Objective To assess the curative effect of microscopic anterior cervical approach in cervical spondylotic diseases. Methods A total of 75 patients were selected, who underwent microscopic subtotal anterior cervical decompres-sion and titanium mesh to fusion fixation or microscopic decompression of resection of the cervical intervertebral disc and cage implant fixation in Tianjin People's Hospital since October 2011 to October 2012. The Cervical vertebra gap involved 1 level in 41 cases, 2 levels in 30 cases and 3 levels in 4 cases. Pateints followed up regularly after operation. The nerve func-tion was assessed using Japanese orthopaedic association scoring system (JOA) function was calculated to examine the im-provement rate and to assess the curative effect of microscopic anterior cervical approach. Results All patients were fol-lowed up. The nerve function recovery was excellent in 44 cases, was well in 25 cases, was general in 6 cases, and the ex-cellent and well recovery rate was 92%. There was no significant difference between excellent recovery rate and well recov-ery rate. There were significant differences in values of each cervical levels between before and after surgery in the last fol-low-up of patients (P<0.05). Conclusion Microscopic operative treatment for cervical spondylotic is safe and effective, with less trauma and bleeding. After surgical decompression, the recovery is rapid in patients with early ambulation.

Objective In order to evaluate the therapeutic effect, to screen effective drugs for AIDS, and to find out the changes of patient's condition, it is necessary to develop an objective method to quantitate the levels of viral load of the patients before and after treatment.Method Differential PCR(D PCR) was used to co amplify the target HIV 1 gag gene and reference template ? globin gene, so as to determine the level of HIV replication quantitatively. The levels of HIV DNA in the peripheral blood mononuclear cells of 8 patients with AIDS were determined quantitatively.Results The levels of the provirus of the 8 patients ranged from 0 508 2 210 copies/?g DNA, there were differences in the levels of replication and integration. Conclusion It is the authors′ opinion that this method is easy to control with an advantage of reliability, quickness and reproducibility, It is suitable to measure clinical specimens, and provides an objective evidence for the evaluation of responses to therapeutic intervention.

Objective:To explore the role of DKK-1 andβ-catenin expressions in progression of proximal gastric cancer (PGC). Methods:The expression of DKK-1 andβ-catenin in 61 cases with PGC and para-neoplastic tissues and 20 cases with normal gastric mucosa was detected by immunohistochemistry. The related clinical significance in the cases was studied. Results:The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in the tissue sections of PGC were 34.4%(21/61) and 68.9%(42/61), respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in para-carcinoma tissues were 8.2%(5/61) and 6.6%(4/61) , respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in normal gastric mucosa were 15.0%(3/20) and 10.0%(2/20), respectively. The expression rate was significantly higher in PGC than that in the other tissues (P<0.05). The expression of DKK-1 was positively related to that ofβ-catenin in PGC (r=0.454, P<0.05), but not in the others. Conclusion:Higher expressions of DKK-1 and the abnormal expression ofβ-catenin are closely related to the occurrence of PGC.

BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect.
OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis.
METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group.
RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.

This study was aimed to observe effects of herbal pair of semen Ziziphi Spinosae (SZS) and A lbizia Julib-rissin flower (AJF) on cognitive function and serum BDNF among depression patients. A total of 60 depression pa-tients were enrolled and randomly divided into two groups. In the SZS-AJF group, 30 patients were administered with SZS-AJF decoction. In the control group, 30 patients were administered with venlafaxine hydrochloride sus-tained-release tablets. Hamilton Depression Rating Scale (HAMD), Wisconsin Card Sorting Test (WCST), and the serum-brain derived neurotrophic factor (BDNF) were detected before treatment and after six weeks of treatment. The results showed that there were no significant differences on the HAMD score, WCST (Response Administered (Ra), Categories Completed (Cc), Correct Responses (Cr), Perseverative Errors (Pe), Non-perseverative Errors (Npe)), serum BDNF before and after treatment between two groups. Compared with pretreatment, HAMD score, Ra, Cc, Cr, serum BDNF were increased after treatment in both groups. The Pe and Npe were decreased after treatment. There was sta-tistical significance between pretreatment and posttreatment (P< 0.05, or P< 0.01). It was concluded that the herbal pair of SZS-AJF has anti-depressant effect. It can improve cognitive function of depression patients. The anti-de-pressant mechanism of herbal pair of SZS-AJF may be related to the increasing of serum BDNF level.

BACKGROUND:Hip arthroplasty and internal fixation are presently effective therapeutic methods in treatment of femoral neck fracture in the elderly. However, which method can reduce the incidence of postoperative complications remains controversial.
OBJECTIVE:To systematical y review the reoperation, postoperative complications and 1-year and 2-year mortality after hip arthroplasty and internal fixation in the elderly with femoral neck fracture.
METHODS:Pubmed/Medline, EMBASE, and Cochrane CENTRAL databases were retrieved by computer for articles published before May 2013. Systematic review on randomized control ed trials of hip arthroplasty versus internal fixation for femoral neck fractures in the elderly was conducted using the Cochrane Col aboration’s RevMan 5.2 software. Outcome measures included reoperation, main complications related to the surgery and mortality.
RESULTS AND CONCLUSION:Six published randomized control ed trials of nine literatures containing 1 496 cases were involved in this review. Meta-analysis results indicated that reoperation rate was greater in the internal fixation group within and more than 2 years after the surgery compared with the hip arthroplasty group (P<0.000 01). Compared with hip arthroplasty group, internal fixation significantly increased the main complications related to the surgery [OR=8.79, 95%CI(6.50-11.88), P<0.000 01]. No significant difference in 1-year and 2-year mortality after surgery was detected between the internal fixation and hip arthroplasty groups [OR=0.85, 95%CI(0.66-1.11), P=0.23;OR=0.88, 95%CI(0.70-1.10), P=0.27]. These data suggested that the long-term reoperation rate and incidence of main complications were obviously higher in internal fixation compared with hip arthroplasty for femoral neck fracture in the elderly, and no significant difference in 1-year and 2-year mortality after the surgery was detectable between the two methods. Clinical recommended hip arthroplasty in the repair of femoral neck fracture in the elderly.

ObjectiveTo summarize the prevention and treatment of complications of carotid angioplasty and stenting (CAS) in the elderly. Methods88 cases (≥60 years) who underwent carotid angioplasty and stenting were collected from our hospital. The prevention and treatment of complications were analyzed retrospectively. ResultsNinety-two self-expanding stents were placed in the 88 cases and the technical success rate was 100%. The degree of stenosis was significantly improved from 82.6% to 13.2%. All patients were followed up for 3-12 months. Carotid sinus reaction was observed in 23 cases (26.1%) and it was more often in ≥70 years group than in 60～69 years group (P＜0.05). Meanwhile, compared with the distance ＞10 mm, Carotid sinus reaition was more often in the distance ≤ 10 mm between carotid bifurcation and maximum stenotic lesion (P＜ 0.05). Hypertension occurred in 6 cases, cerebral hyperperfusion syndrome in 4 cases including 1 case of cerebral hemorrhage. There were cases with cerebral ischemia in 1 case, cerebralvaseular spasm in 4 cases, acute renal insufficiency in 3 cases and ecchymosis and hematoma at the puncture site in 7 cases. There were 3 cases of transient ischemic attack, 1 case of myocardial infarction, 1 case of cerebral hemorrhage, 2 cases of mild neurological deficits and no death occurred during the period of follow-up. ConclusionsThere is higher risk for elderly patients undergoing CAS, but careful preoperative preparation and properly treatment may avoid the occurrence of complications.

Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.

Objective To study the method of using phantom test for daily quality assurance of on board image(OBI) system. Methods The routine procedures of radiotherapy, including CT simulation, planning,setup,cone beam CT(CBCT) scan and kilovolt X-ray orthogonal film were carried out on a head phantom. The procedures repeated once a day in the following 10 days. The geometric errors of the phantom were recorded. Results The geometric errors of the phantom by CBCT were [0.06±0.11] cm, [0.03±0.05] cm, [0.07±0.07] cm and [0.03±0.10] cm in longitudinal, vertical, lateral and rotation directions, respectively. The geometric errors of the phantom by kilovolt X-ray orthogonal film were [ 0.04±0.10] cm, [0.03±0.05] cm, [0.08±0.06] cm and [0.05±0.05] cm, respectively. The differences of geometric errors of the phantom by CBCT and kilovolt X-ray orthogonal film were not significant(t = 0.44,P=0.667 in longitudinal direction ; t=0.00, P=1.060 in vertical direction ; t=0.34, P=0.735 in lateral direction; t=0.58,P=0.568 in rotation direction). Conclusions The OBI system of our accelerator is reliable and at excellent performance status. The method by using phantom test for the daily quality assurance of OBI system is easy and reliable.

Objective To explore the causes and risk factors affecting early death in patients with traumatic cervical spinal cord injury (SCI). Methods Clinical data of 553 patients with traumatic cervical SCI were analyzed retrospectively to discuss the related factors affecting early death of patients with traumatic cervical SCI by using univariate analysis and multivariate logistic regression analysis. Results The early mortality of the patients with traumatic cervical SCI was 4.0% ( 22/553 ). The main causes of the early death were respiratory failure in nine patients (40.9%) and electrolyte disorders in five (22.7%). Univariate analysis showed that age, cervical spinal cord injury severity, complications in respiratory, cardiovascular, digestive systems and electrolyte disturbance as well as tracheotomy were considered statistically significant for early death in patients with traumatic cervical SCI ( P < 0, 05 ). Multivariate logistic regression analysis showed that age, cervical SCI severity, complications in respiratory,cardiovascular system and electrolyte disturbance as well as tracheotomy. Conclusion Severe cervical SCI, combined respiratory, cardiovascular system and electrolyte disorder complications as well as tracheotomy are high risk factors for the early death in patients with traumatic cervical SCI.