OBJECTIVE:To investigate the influence of nitrogen monoxide(NO) donor,sodium nitroprusside(SNP),on mRNA expression of sodium/iodide symporter(NIS) in thyrocyte membrane cultured in vitro in order to interpret molecular mechanism that NO inhibits the uptake of iodide.METHODS:The effect of SNP at different concentrations(0,10-6,10-5,10-4,10-3 mmol?L-1) on mRNA expression of NIS in thyrocyte by using cell culture method and RT-PCR with optical density ratio of NIS/?-actin as index.RESULTS:Optical density ratio of NIS/?-actin in each group decreased in order after treated with SNP(0,10-6,10-5,10-4,10-3 mmol?L-1).NO inhibited mRNA expression of NIS in a dose-dependent manner(P

With the change of diet and lifestyle,the development of medical concepts and techniques,the spectrum of disease has changed dramatically. The standardization of gastrointestinal surgery will be the key to further improvement.Endoscopic ultrasonography,computed tomography,magnetic resonance imaging, positron emission tomography-computed tomography and laparoscopy are helpful for preoperative staging of gastrointestinal carcinoma.The standards of operation,such as D2 lymph node dissection for gastric cancer and total mesenteric excision for rectal cancer,are also very important.Creating standards for multi-disciplinary treatment of gastrointestinal diseases will be important factors for improving outcomes.

Objective To evaluate the clinical value of humeral antegrad e interlocking nails. Method 21 patients with humeral shaft fracture were treate d with open reduction and internal fixation with antegrade interlocking nail. Re sult The patients were followed up for 3 to 20 months (mean 14.6months). All pat ients acquired bone healing, and only one case had temporary injury of radius ne rve. Conclusion The humeral antegrade interlocking nail is an effective method t o treat humeral shaft fracture, with advantages of good elbow function and less complications of infection and injury of radius nerve.

Myocardial ischemia/reperfusion(MI/R) injury refers to restoring blood perfusion after myocardial ischemia for a relatively long time, but the tissue appears more obvious and severe myocardial damage and dysfunction than before reperfusion, this phenomenon mainly relates to inflammation, oxidative stress, cell apoptosis, cell autophagy and so on.NF-κB is a nuclear transcription factor involved in regulating a variety of pathophysiological processes, which also plays an important role in all aspects of MI/R injury.The in-depth study of NF-κB in MI/R injury and clinical application of related research will provide new ideas and methods for treating MI/R injury.

ObjectiveTo assess the clinical value of minimally invasive transforaminal lumbar interbody fusion(TLIF) through the Wiltse approach for the treatment of lumbar spondylolisthesis. Methods Sixty-nine patients with lumbar spondylolisthesis were randomly divided into two groups. Group A underwent minimally invasive TLIF via the Wiltse approach, Group B via the traditional approach. There were 31 cases in group A, the affected level was L4.5 in 19 cases and L5S1 in 12. The degree of vertebrae slippage was Ⅰ degree in 17 cases,and Ⅱ degree in 14. There were 38 cases in group B, the affected level was L4,5 in 22 cases and L5S1 in 16. The degree of vertebrae slippage was Ⅰ in 21 cases, and Ⅱ in 17. The Japanese Orthopaedics Association (JOA) score, visual analogue scale (VAS) of low back pain and leg pain were evaluated at 3, 6, and 12 months follow-up. The post-operative dynamic X-rays, CT and/or MRI were used for image evaluation. ResultsThere was no statistically difference in operating time between the two groups. The incision length, blood loss and exposing time of group A were shorter than those of group B. The JOA scores, recovery rate, VAS of low back pain and leg pain, interbody fusion rate and atrophy rate of multifidus in group A were 24.7±3.5, 77.0％±3.1％, 1.0±0.7, 1.1±0.3, 71.0％±5.8％, 2.1±0.2, respectively, and in group B were 24.3±2.8, 73.6％±6.4％, 3.1±0.6, 1.8±0.5, 76.3％±6.1％, 0.5±0.1, respectively. The VAS of low back pain was lower in group A than in group B. The atrophy rate was better in group A than in group B. Conclusion Both TLIF approaches can acquire satisfactory clinical results. Minimally invasive TLIF through the Wiltse approach can significantly reduced damage of multifidus and incidence of chronic low back pain postoperative.

Objective To report the results using endoscopic techniques in ce rvical discectomy and intervertebral fusion. Methods From October 2002 to August 2003, 26 patients underwent cervical discectomy and intervertebral fusion using endoscopic techniques. 16 patients had been followed-up more than 3 months, inc luding 4 females and 12 males. The average age was 53.2 years (range, 23 to 65 y ears). The disorders lasted from 3 to 14 months before surgery. There were 3 cas es of cervical injury associated cervical disc herniation (CDH), 8 of cervical s pondylotic myelopathy (CSM), 2 of solitary ossification of the posterior longitu dinal ligament (OPLL), and 3 of radiculopathy. The mean preoperative ADL of Japa nese Orthopedic Association (JOA) score was 7.2. The working channel was inserte d through a 2 cm long incision, the protruded discs or ossified posterior longit udinal ligaments were excised for complete decompression, then an appropriate in tervertebral PEEK fusion cage was implanted. Results All patients obtained endos copic cervical discectomy and interbody fusion successfully. None of cases was c onverted to open procedures. The surgery lasted an average of 120 min (range, 50 to 150 min), mean blood loss was 110 ml (range, from 40 to 140 ml). There was n o complication during operation and no any stimulating symptoms on laryngopharyn x after surgery. However, postoperative hemorrhage of the incision occurred in 1 case, then an injury of a thyroid vessel was found during immediate exploration . The follow-up period extended from 3 to 8 months (mean, 6.5 months), the aver age preoperative ADL of JOA score was 13.1 while the improvement rate was 60.2%. Conclusion The cervical discectomy and intervertebral fusion through endoscopi c approach is able to reduce the soft tissue injury and the incidence of stimula ting symptoms on laryngopharynx, which makes the surgery more safe. The indicati ons for this procedure include cervical disc herniation, cervical myelopathy, ra diculopathy, and traumatic cervical disc injury on C3,4 to C5,6 segments.

Objective To summarize the imaging features of the thoracic canal stenosis caused by ossification of ligamentum flavum, and to evaluate its clinical results of a novel decompression of total laminotomy and autografting in-situ. Methods 31 patients underwent total laminotomy, autografting in-situ and decompression to treat the ossification of thoracic ligamentum flavum. In the study, there were 18 males and 13 females; the average age was 45.7 years (rang, 26 to 73). 3 patients were associated with cervical stenosis, 5 with lumbar stenosis, and 2 with both cervical and lumbar stenosis. 9 were associated with anterior compression by thoracic disc herniation or OPLL. The vertebrae affected were 1 level in 3 patients, 2 levels in 12, 3 levels in 11 and more than 4 levels in 5. 23 affected segments were located at the upper thoracic spine(T1-T4), 19 at the mid-thoracic spine(T5-T8) and 52 at lower-thoracic spine(T9-T12). All the patients underwent total laminotomy and autografting in-situ, 9 patients with thoracic disc herniation or OPLL received discectomy and internal fixation at one stage. The postoperative outcomes were evaluated according to Epstein criteria. Results The patients were followed up 6 to 63 months (mean, 15 months). The clinical outcomes were excellent in 14 cases, good in 7 cases, and fair in 3 cases, and the excellent and good rate was 87.5%. One case experienced neurological complication with Frankel C grade improved to Frankel D grade treated with neurotrophic drug and hyperbaric oxygen and to Frankel E grade at 5 months after operation. 2 presented with lower limb intravenous thrombosis, and CSF leakage happened in 1 case and cured with re-operation. The osteotomy of total laminotomy was bony healed at average of 5.5 months, and there was not new formed ossification anterior to re-implanted vertebral lamina and spinal cord compression. Conclusion MRI combined with CT scanning is a most useful imaging modality for the diagnosis of ossification of thoracic ligamentum flavum. The novel surgical procedure designed by the authors is safe and effective in treating ossification of thoracic ligamentum flavum.

Objective To observe the clinical advantage of treating the dens fracture with cannulated screws by microendoscopy system and navigation system through anterior approach. Methods From October 2002 to August 2004, 6 dens fracture (type Ⅱ) patients had undergone single cannulated screws fixation by the microendoscopy system and image guidance through the anterior approach, including 2 females and 4 males with an average of 53.2 years (range from 23 to 65 years). The preoperative Frankel grade was D in 1 case and E in 5 cases. 4 cases had fracture displacement. All patients accepted skull traction and external fixation before surgery. The patients accepted the MR examination and the images were reconstructed by the Vector Vision spinal navigation system in order to make the proper surgical plan, including the nails' direction and length in three-dimension. After affirming the reduction of the dens fractures according the C-arm fluoroscopy, the work channel was inserted through 2 cm long incision at the C5 level, then extended to the C2 level, to excise part of inferior C2 vertebral body. Under the navigation system guide, a guidance needle was inserted and the fracture was fixed by cannulated screw through the work channel. The patients did not need any C-arm fluoroscopy during the surgery. After the surgery the patients were with external fixation for 2 months. Results The surgery lasted 80 min (range from 50 to 150 min), blood loss was 75 ml (40 to 90 ml). There was no related complication during and after surgery including odynophagia or dysphagia. Follow-up period extended from 6 to 37 months (mean 13.5 months). All dens fractures were reduced and healed satisfactory during the follow up. All patients' postoperative Frankel grade was E in the most recent follow-up. Conclusion To fix the dens fracture through microendoscopy and navigation system guide can reduce the soft tissue injury and the incidence of odynophagia or dysphagia, make the surgery safer, avert the repeated C-arm check-up during the surgery compared with the traditional anterior fixation method. The procedure is very safe, simple and can reduce the surgical time effectively.

The application of molecular biological technique provides opportunity to pancreatic cancer patients since the cancer is resistant to routine treatment. Clarifying the molecular mechanism in the genesis and development of pancreatic cancer is the first thing to do. Recent researches found that there were different signaling pathways activated in different stages of pancreatic cancer. The important signal pathways included mitosis pathways, growth factor pathways, developing pathways and mucin pathways. This article will review the relationship between molecular pathways and pancreatic cancer.

[Objective] To observe the influence of blood-nourishing and wind-expelling therapy on the therapeutic effect of epidermic grafting for vitiligo. [Methods] Sixty-two patients with vitiligo were allocated to group A (n = 32) and group B (n = 30) with simple random method. Group B was treated with epidermic grafting. Group A was treated with oral use of Baibofeng Decoction (mainly composed of Radix Angelicae Sinensis, Caulis Spatholobi, Radix Saposhnikoviae, Fructus Psoraleae, Radix Paeoniae Rubra , Radix Salviae Miltiorrhizae, etc.) 2 weeks after epidermic grafting was performed, one dose every other day, and with external application of Fubu tincture (composed of Fructus Psoraleae, Radix Angelicae Dahuricae, Radix Salviae Miltiorrhizae and Flos Carthami) bid. After treatment, the short-term and long-term therapeutic effect was observed in the two groups. [Results] The cure rate was 83.6% and the effective rate was 93.1% in group A, and respectively 71.0% and 88.5% in group B, the therapeutic effect of group A being better than that of group B (P