Objective To explore the application value of self-made directional arcuate bone drill during vertebroplasty by observing its operative effects for osteoporosis in vitro . Methods EDTA-Na2 was used to soak the prepared vituline osteoporotic vertebral bodies in vitro .A total of 40 osteoporotic vertebral bodies were randomly divided into Group A and B , with each group having 20 vertebral bodies for vertebroplasty .The Group A underwent a puncture by routine straight bone drill , while the Group B received a puncture by self-made directional arcuate bone drill with the arc directing toward the contralateral , which terminated when the drill reached the first 1/3 of vertebral body .Finally, statistical analysis was conducted on the distance between the bone drill bit and exterior margin of contralateral vertebral body , as well as whether bone cement reached or went over the vertebral sagittal midline . Results The osteoporotic vertebral bodies were successfully prepared in vitro by using EDTA-Na2 immersion decalcifying for 9 days. In the Group A, the drill bit was (2.50 ±0.32) cm away from contralateral exterior margin of vertebral bodies , which was significantly different from that in the Group B (0.90 ±0.26) cm (t=17.354, P=0.000).The bone cement reached or went over the vertebral sagittal midline in 11 vertebral bodies in the Group A and in 19 vertebral bodies in the Group B , with statistical difference ( Fisher’ s test,P=0.004).The intraspinal bone cement leakage occurred in 9 vertebral bodies in the Group A and 4 in the Group B, without significant difference between the two groups (Fisher’s test,P=0.176). Conclusion The self-made directional arcuate bone drill can build an osseous channel that reach or go over the vertebral sagittal midline and guide bone cement distributed to contralateral puncture , which avoids the disadvantages of bilateral vertebral pedicular puncture .The result shows that the self-made directional arcuate bone drill has more adventages in vertebroplasty than that of traditional straight bone drill but doesn ’ t have significant advantages in preventing bone cement leakage .

Objective To study the protective effects of vitamin E combined with Rhodiola rosea on the injury in mice skeletal muscle through hypoxia with exercise training and research the mechanism of action.Methods Forty ICR mice were randomly divided into control group and observation group,20 mice in each group.The control group was given Vitamin E (40 mg·kg-1·d-1),and the observation group was given Vitamin E (40 mg·kg-1·d-1)combined with Rhodiola rosea (20 g·kg-1·d-1);the rats in the two groups were treated with hypoxia (11.3%) for 4 weeks (5 ℃,15 m/min,60 min/d) after 15-day drug using.After the last training,all the mice were euthanized and then detected the gene of Bax and Bcl-2 mRNA through the RT-PCR in the skeletal muscle and the activity of GSH-PX,SOD,ROS,the concentration of MDA in the skeletal muscle.During the period (pretrain and 1,2,4 weeks) of hypoxia combined with exercise training,the CK,LDH in the serum were detected.Results The expression of CK and LDH in the observation group were lower than those of the control group (P<0.05).The activity of GSH-PX and SOD in the skeletal muscle of the observation group was significantly higher than that of the control group (P<0.05),while the ROS and MDA were lower than those of the control group(P<0.05);the expression of Bax mRNA and Bax/Bcl-2 of the observation group was significantly lower than that of the control group(P<0.05).While the expression of Bcl-2 mRNA was significantly higher than that of the control group(P<0.05).Conclusion Rhodiola rosea combined with Vitamin E can inhibit the expression of apoptotic genes by correcting the oxidation and hypoxia imbalance under hypoxia.

ObjectiveTo investigate the efficacy of raltitrexed combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced colorectal cancer with liver metastasis. MethodsA total of 80 patients with liver metastasis of advanced colorectal cancer who were admitted to Central Hospital of China National Petroleum Corporation and underwent surgery from January 2012 to June 2015 were enrolled and randomly divided into study group and control group, with 40 patients in each group. The patients in the study group underwent hepatic arterial infusion chemotherapy with raltitrexed combined with TACE, and those in the control group were treated with intravenous infusion of raltitrexed alone. The above treatment was performed once every 4 weeks for 3-6 cycles. The response rate (RR), disease control rate (DCR), median time to disease progression, survival rate, and reductions in carcinoembryonic antigen (CEA), CA19-9, aminotransferases, and bilirubin were observed in the two groups. The chi-square test was used for comparison of categorical data between groups. ResultsRR, DCR, and the median time to disease progression showed significant differences between the study group and the control group (45.0% vs 22.5%, χ2=4.528, P=0.033; 70.0% vs 47.5%, χ2=4.178, P=0.041; 17.9 months vs 10.5 months, χ2=2408, P＜0.001). The study group had significantly higher 1- and 2-year survival rates than the control group (80.0% vs 57.5%, χ2=4.713, P=0.030; 55.0% vs 32.5%, χ2=4.114, P=0.043). The study group had a significantly higher number of patients with more than 50% reductions in CA19-9, CEA, aminotransferases, and bilirubin at 2 months after TACE than the control group (χ2=5333, 4528, 5051, and 5.013, P=0.021, 0.033, 0.025, and 0.025). ConclusionRaltitrexed combined with TACE is of good value in the treatment of advanced colorectal cancer with liver metastasis and holds promise for clinical application.

Objective To assess the clinical effect of Percutaneous transforaminal endoscopic spinal surgery for central lumbar spinal stenosis.Methods Total 92 patients (44 males and 48 females with average age of 68.6± 12.4 years) with central lumbar spinal stenosis were enrolled in our study during February 2012 and July 2016.All patients were treated with Percutaneous transforaminal endoscopic spinal surgery.Clinical and Radiographic evaluation were investigated on 1 week,3 months,6 months,12 months postoperatively and final follow-up.Visual analogue scale (VAS) for low back pain and leg pain,Oswestry disability index(ODI) for low back pain were used to evaluate the clinical efficacy of surgery.Pre and postoperative Dural sac cross sectional area(DSCA) was measured.And the correlation between changes of DSCA and clinical efficacy was analyzed.Results The operation time was 45-1 15 min.The mean operation time was 75±15 min.the mean blood loss was 15±5 ml (range 8-50 ml).All patients were followed for 12-46 months (24.5±5.3 months).VAS for low back pain,VAS for leg pain,and OD1 were significantly improved from 6.75± 1.28,7.79± 1.15 and 39.82％ ±5.06％ preoperatively to 2.21± 1.08,2.16± 1.14 and 9.82％ ±3.69％ at the latest follow-up.Dural sac cross sectional area significantly increased from 55.35±12.18 mm2 preoperatively to (102.36±15.38) mm2 at the latest follow-up.Correlation coefficient with DSCA change was-0.480 for ODI change,-0.612 for VAS(low back pain) change,-0.637 for VAS (leg pain)(P ＜ 0.05);obvious positive correlation existed between the change of DSCA and patient's clinical efficacy.It showed that the change of DSCA was positively correlated with the patient's clinical efficacy.The clinical results were excellent in 56 cases.good in 29,fair in 4,and poor in 3 based on the MacNab criteria.92.39％ demonstrated a good-to-excellent outcome.One case occurred cauterizing syndrome,3 cases of recurrence,and 2 cases of Dural tear.There was no severe vascular or nerve injury.Conclusion Percutaneous transforaminal endoscopic spinal surgery provides a new minimally invasive treatment for central lumbar spinal stenosis.It is safe and effective.It is found that the change of DSCA is positively correlated with the clinical efficacy of surgery.

Objective To investigate the correlation between type H hypertension and the development of coronary atherosclerosis.Methods From January 2015 to December 2016,three hundred and sixty patients with essential hypertension complicated with coronary atherosclerosis were treated in First Hospital of Shijiazhuang were selected,according to the level of serum homocysteine (Hcy),the patients were divided into the observation group (n =197 cases,Hcy ≥ 10 μ mol/L) and the control group (n =163 cases,Hcy＜10 μmol/L),all patients underwent coronary angiography and intravascular ultrasound.Results The cross-sectional area of extravascular elastic membrane (EEMCSA),plaque area (PA) and plaque burden(PB) of the observed group were (15.10±0.91) mm2,(8.80±0.99) mm2 and (62.03±3.20)％,wrere obviously higher than thoseat of the control group((13.72±0.96) mm2、(7.92±0.89) mm2、(56.87 ±3.37) ％),and the difference was statistically significant (t =14.079,、8.864,and 14.983,P＜0.05),and the minimum lumen cross section area (MLA) was (5.40 ±0.64) mm2,were obviously lower than that of the control group ((5.89 ± 0.52) mm2),and the difference was statistically significant (t =-7.937,P＜0.05);The Gensini score of the coronary artery in the observation group was (67.64± 13.19) points,which was significantly higher than that in the control group ((55.34± 12.20) points),and the difference was statistically significant (t =9.190,P＜0.05);the Serum Hcy were positively correlated with PA,PB and Gensini scores in the observation group (r =0.873,0.732and 0.856,P ＜ 0.05),which was negatively correlated with MLA (r =-0.773,P＜0.05).Conclusion There is a certain correlation between the severity of coronary atherosclerosis and the level of serum Hcy in patients with type H hypertension,which is worthy of further study.

BACKGROUNDIt is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention. The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.

METHODSBlood samples of eight patients were taken before the first exposure to ionizing radiation, 10 minutes, 20 minutes, 30 minutes, 1 hour, and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics. Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group. Blood samples were taken before coronary angiography and 15 minutes after the last exposure. By enumerating γ-H2AX foci, the impact of prolonging the interval on DNA double-strand breaks was investigated. Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.

RESULTSAn increase in foci was found in all patients received percutaneous coronary intervention. The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure. There was no statistically significant difference between the two groups in γ-H2AX foci at baseline. On average there were (0.79 ± 0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66 ± 0.21) in the intermittent radiation exposure group after exposure (P < 0.05).

CONCLUSIONSA significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures. The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.

Adult ; Coronary Angiography ; adverse effects ; DNA Breaks, Double-Stranded ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Humans ; Lymphocytes ; metabolism ; radiation effects ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects