With the development of modem tumor diagnostic techniques and therapies, the survival rate of malignant tumor has been remarkably increased. With the increase in survival rate of cancer-beating patients, the chance of tumor metastasis is elevated. Minimally invasive treatment provides a new strategy to the therapy of spinal metastatic carcinoma. Its benefits include smaller surgical wound,, higher efficacy and fewer complications, and thus have a broad application prospects in the field of spinal metastatic tumors. In this article, a general re-view is given on minimally invasive treatments of spinal metastatic carcinoma, as well as the latest progress in the field. It was proposed that the united application of the treatment might be a promising hot spot of tumor therapy.

Poly lactic-co-glycolic acid (PLGA) has been attracting increasing attention in the field of bone tissue engineering because it is a biodegradable polymer with excellent biocompatibility, controllable aperture and porous rate, and a degradation rate which is suitable for bone regeneration, and moreover a suitable carrier for the sustained release of growth factors. This article reviewed the recent research progress in PLGA as a material for controlled drug delivery with emphasis on how to make the scaffold more suitable for the regeneration of the bone and which is the better way to apply sustained release of growth factors embedded in the material in bone tissue engineering. It pointed out that PLGA carrying different growth factors will become the focal point in the field of bone tissue-engineering.

Objective To assess the feasibility of using biodegradable poly (lactic-co-glycolic acid) (PLGA) scaffold with controlled release of rhBMP-2 and its effect on the osteogenic activity of MSCs in vitro. Methods The PLGA scaffolds with rhBMP-2 sustained release system were made by combination of porogen-leaching and freeze-drying. The drug release kinetics was measured by enzyme-linked immunosorbent assay (ELISA) in vitro. MSCs were isolated from the bone marrow of human and cultured for 3 passages. Then, MSCs were seeded onto PLGA scaffolds. PLGA scaffolds without rhBMP-2 were used as experimental controls . Scanning electron microscopy(SEM) was used to observe the morphology of MSCs. The cell proliferation was determined by MTT assay. Results The rhBMP-2 was encapsulated into PLGA scaffolds and it was found to be continuously released from the scaffolds. The scaffolds have evident enhancing effect on ectopia osteogenesis. Conclusion PLGA scaffold containing rhBMP-2 is a new promising tissue engineering scaffold.

Objective To explore the clinical therapeutic effects in arterial interventional therapy in early osteosarcoma patients.Methods Thirty-eight early osteosarcoma patients received arterial chemoembolization therapies and performed operations.94.7% patients received limb salvage surgeries.Levels of alkaline phosphatase were tested in preoperative and postoperative phases.Results Levels of postoperativealkaline phosphatase[average(191.7±107.0)U/L]were significantly decreased compared with that before interventional therapy[average(1129.1±572.3)U/J.The survival rate in follow-up at 1,3 and 5 years Was97%,79%,50% respectively.The rate of recurrence and metastasis WAg 24%.Conclusions Arterialchemoembolization therapies in patients with early osteosarcoma could improve clinical symptoms effectively,enhance survival rate,relieve recurrence and metastasis,remain affected extremity.The clinical thempeutic effects of iodinated oil were the best among the three embolism materials.

BACKGROUND: As indicated by experiments on animal, cytokine has regulatory effects on sleep. Clinical research has found abnormal level of cytokine in patients with depression. Sleep rhythm disorder is a common symptom of depression; however, the relationship between cytokine and sleep has hardly been conducted at home and abroad.OBJECTIVE: To explore the relationship between abnormal level of cytokine and clinical characteristics of sleep disorder so as to provide theoretical basis for early intervention and functional detection of sleep disorder in patients with depression.DESIGN: A case-controlled study using the patients with depression as the subjects and normal persons as the controls.SETTING: Two wards of the Department of Psychiatry of a university hospital.PARTICIPANTS: The study was completed in the Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College. The subjects in this study were divided into depression group and control group. The patients in depression group were hospitalized in the Second Affiliated Hospital of Xinxiang Medical College from September 2001 to December 2001. Inclusion International Classification of Diseases(10th edition) and Chinese Classifiliver function, electrocardiography and kidney function examination were quilizer or lithium salt were used in the past year; had the history of alcohol Had endocrine, heart, liver and kidney diseases and other serious somatic diseases. The 35 patients who met the above criteria were 14 males and 21females aged from 18 to 60 years with the average age of(36 ± 12) years in the depression group. In the control group there were 13 males and 17 females aged from 19 to 60 years with the average age of(34 ± 10)years.METHODS: The levels of plasma interleukin-2(IL-2) and solute interleukin-2 receptor(sIL-2R) were detected with enzyme-linked immunoadsorbent assay.disorder in patients with depression.RESULTS: The level of plasma IL-2 in the depression group(77.92± 36.85) pg/L was lower than that of the normal control group (98.98± 30. 72 ) pg/L( t = 2. 446, P ＜ 0.05). Moreover, IL-2 level was positively correlated to depth of sleep level( r = 0. 364, P ＜ 0. 05) . No significant difference in sIL-2R level was found between the two groups( P ＞ 0.05).CONCLUSION: The development of sleep disorder in patients with depression may be related with the level of cytokine, and the decrease of IL-2level can be the neurobiological basis of sleep level in depression.

Objective To compare the clinical results of two different anterior cervical surgical treatment for multi-segmental cervical spondylotic myelopathy (≥3 segments).Methods Twenty-three patients with segmental cervical spondylotic myelopathy,10 cases were treated with anterior cervical discectomy and fusion (ACDF) as ACDF group,13 cases were treated with anterior cervical corpectomy and fusion (ACCF) as ACCF group.The operation time,operative blood loss,JOA scores,neurological improvement rate and the variable of the D value were compared.Results The operation time and operative blood loss in ACDF group was significantly lower than that in ACCF group [(130.0 ±31.5) min vs.(150.0 ±42.5) min,(150.0 ± 120.8) ml vs.(310.0 ± 320.8) ml,P ＜ 0.05].The variable of the D value in ACDF group was significantly higher than that in ACCF group [(3.1 ± 1.4) mm vs.(2.3 ± 0.9) mm,P ＜ 0.05].There was no statistically significant difference in JOA scores,neurological improvement rate between ACDF group and ACCF group.Two cases of cerebrospinal fluid leakage in ACDF group,the oppression and drainage recovery after treatment.One case of 14 d after fistula complications in ACCF group,after patching were cured; 2 cases of titanium mesh shift,follow the fusion.Conclusions Both methods attain good clinical results.ACDF combined with ACCF treatment of multi-segmental cervical spondylotic myelopathy,with shorter operation time,relatively less blood loss,and better restoration of cervical sagittal alignment.

Objective To observe effects of hydroxyethyl starch(130/0.4,voluven)on tissue perfusion and serum TNF-α,IL-6,IL-8 levels in patients with severe acute pancreatitis(SAP).Methods 60 SAP patients with non-operative treatment were randomly divided into voluven group and Ringer's solution group(n =30 per group).In addition to conventional drugs and treatment,of which voluven group daily 15ml/kg intravenously for 5 d;Ringer's solution group daily 20ml/kg intravenously for 5d.Hemodynamic parameters and tissue perfusion indicators were monitored,TN F-α,IL-6,IL-8 levels were examined after treatment 0,12,24,48,96 hours.Results Compared with Ringer solution group,Voluven group therapy high efficiency,faster raise MAP,ScvO2,Phi value,lower HR,Hct(t =2.785,3.126,4.132,3.168,2.218,all P ＜ 0.05).TNFα,IL-6 after 48h treatment,IL-8 after 96h treatment,both groups were significantly decreased,but the voluven group was significantly lower than Ringer's solution group(P ＜ 0.05).Conclusion Voluven could effectively and quickly maintain hemodynamic stability,improve the hemorheological and tissue perfusion,could be more conducive to improving the pancreatic microcirculation,thus inhibiting inflammatory cytokines TNF-α,IL-6,IL-8 release,and had favorable treatment effect on patients with SAP.

AIM　To investigate the structures and immunomodulation activity of four homogeneous polysaccharides: LBP 1a-1, LBP 1a-2, LBP 3a-1 and LBP 3a-2 isolated from Lycium barbarum L. brought from Zhongning County, Ningxia Province. METHODS　Their molecular weights, sugar component (constituents) and their linkages were determined by gel permeation chromatography, acid hydrolysis, periodate oxidation and NMR spectrum. The activity of immunomodulation was evaluated with splenocyte proliferation by ［3H］-TDR incorperation, in vitro. RESULTS　Four polysaccharides with molecular weights 11.5×104, 9.4×104, 10.3×104 and 8.2×104, were shown to enhance splenocyte proliferation induced by ConA. LBP 1a-1 and LBP 1a-2 were α-(1→6)-D-glucans. LBP 3a-1 and LBP 3a-2 were found to be α-(1→4)-D-polygalacturonans. CONCLUSION　The four polysaccharides were first isolated from this plant. Polysaccharides with main chain of α-(1→4)-D-polygalacturonans showed stronger immunomodulation activity.

Objective To analysis the MRI features of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), to improve the understanding of MRI manifestations of this disease. Meth?ods The clinical manifestations, neuroimaging analysis and genetic analysis were performed in the CADASIL pedigree proband and his families. Results Five of six cases were confirmed with C2182T mutation on exon 14 of the NOTCH3, of which three cases were diagnosed by MRI. Brain MRI findings included bilateral symmetric distributed confluent lesions in the subcortical and periventricular white matter in the frontal lobe, hypointensity on T1WI and hyperintensity on both T2WI and T2 FLAIR imaging in four cases. The external capsule was involved in three cases, with hyperintensity on T2WI. Subcortical lacunar lesions (SLLs) were shown in three cases. Lacunar infarction in the basal ganglia and thalamus were presented in four cases. T2WI hyperintensity at the brain stem was found in two cases. Cerebral microbleeds were re?vealed in three cases. There was no O’Sullivan sign in all the six cases. Conclusions There is characteristic change of MRI in CADASIL patients, which may play a very important role in screening these cases.

Objective To optimize combined CT pulmonary angiography (CTPA) and renal venography (rCTV) and to evaluate its value for the detection of venous thromboembolism in patients with nephrotic syndrome (NS).Methods Ninety NS patients suspected of venous thromboembolism because of abnormal D-dimer value were included in this prospective study.The first 45 patients were defined as group 1 (protocol 1).These patients underwent CTPA,then rCTV 25 s after CTPA,last inferior vena cava scanning after another 25 s.The following 45 patients as group 2 (protocol 2).These patients underwent CTPA and then inferior vena cava scanning 50 s after CTPA,3 patients in group 2 were excluded because of unavailable CTPA or rCTV.Vessel enhancement of CTPA and rCTV,and radiation doses for two protocols were compared with independent sample student t test.Incidence and distribution of pulmonary embolism and renal vein thrombosis were recorded and compared by using Chi-square test.Results Enhancement values of pulmonary trunk for groups 1 and 2 were (335.5 ± 111.3) and (335.0 ± 76.0) HU,right renal vein were (142.7 ±33.3) and (140.7 ±25.9) HU,left renal vein were (141.6 ±26.4) and (138.8 ±33.6) HU respectively,without any statistical difference (t values were 0.026,0.322 and 0.452,P ＞0.05).Radiation dose to the patients receiving protocol 2 were lower than that of patients receiving protocol 1 [volume CT index,(19.7 ± 4.3) vs (13.6 ± 3.0) mGy; dose length product,(1019.9 ± 878.5) vs (532.0 ± 132.9) mGy · cm; both P ＜0.01].Of 87 NS patients,44 venous thromboembolism events were detected,resulting in the incidence of 50.6％ (44/87),including pulmonary embolism in 19 patients,renal vein thrombosis and pulmonary embolism in 17,renal vein thrombosis in 7,and inferior vena cava in one patient.The detection rate were 48.9％ (22/45) and 52.4％ (22/42),there was no significant difference (x2 =0.106,P =0.745).Conclusion Combined CTPA and rCTV with protocol 2 (CTPA and inferior vena cava phase scanning 50 s after CTPA) is suitable to clinical application and pulmonary embolism is the most common thromboembolism complication in NS patients.