Objective:A method that is based on microfluidic cell chip technology was developed for the first time to analyze CD14+monocyte myeloperoxidase (MPO) expression in myelomonocytic leukemia (M4) patients. CD14+monocyte MPO expression in M4 patients was preliminarily discussed. Methods:a. The chip was prepared by using polydimethylsiloxane as the host material and by secondary foam molding. b. A total of 48 clinically diagnosed M4 patients and 52 patients with normal myelogram were included as the test and control groups, respectively. c. A method based on the microfluidic cell chip approach was established to detect CD14+mono-cytes and to determine the positive rate and degree of MPO expression in the cells. d. The microfluidic cell chip technique was used to compare CD14+monocyte MPO expression in M4 patients with that in the control. Results:a. The designed microfluidic single cell analysis chip allowed the entry of granulocytes into the corresponding microfluidic channels. Thus, blood cells were separated. Numer-ous ghost corpuscles surrounded the separated white blood cells (WBCs). WBC morphology did not show obvious changes. b. The posi-tive rate of MPO expression and the activity of CD14+monocytes in the bone marrow of M4 patients were significantly higher than those in the bone marrow of the control (P<0.05). Conclusion:A method based on microfluidic single cell technology was developed for the first time to analyze the MPO expression in CD14+monocytes. CD14+monocyte MPO activity in M4 patients was significantly higher than in the control. CD14+monocyte MPO activity can be used as an auxiliary examination marker for clinical diagnosis.

ObjectiveTo investigate the role of SAA in rheumatoid arthritis(RA) pathogenesis by analyzing the expression of serum amyloid protein A(SAA) in serum,synovial fluid and synovial membrane in patients with RA.MethodsSAA levels in the serum and synovial fluid in each group were detected.Sera SAA was tested by Western blotting,while the expression of SAA in RA and osteoarthritis(OA) synovium was detected by immunohistochemistry.Comparisons between groups were performed by t-tests or KruskaWallis test.ResultsThe serum levels of SAA were significantly higher in RA [(318±132) μg/L] than those in OA [(127±47) μg/L] and healey controls [(127±41) μg/L,P＜0.01].In RA,the SAA levels in the synovial fluid [ (571±473) μg/L ] were significantly higher when compared to those in O A [ (129±33) μg/L](t=2.46,P=0.04).Western blotting results showed that SAA bands were found in the serum samples of each group,and higher expression of SAA were seen in RA.Pathology study had showed that SAA was observed mainly in endothelial cells,synovial fibroblasts,macrophages and perivascular areas in RA synovium.In OA,SAA was observed in perivascular areas and synovial fibroblasts.ConclusionIn RA,SAA levels in both serum and synovial fluid are significantly higher than those in the controls.High expression of SAA in RA synovium can be observed.Our results suggest that SAA may play a role in inflammation reaction and joint destruction of RA.

Objective To investigate the pathogenesis in patients with uterine leiomyoma complicated by amyloidosis. Methods A total of 36 uterine leiomyoma patients were recruited in this study, and divided into two group by Congo red staining:amyloidosis group (n=6) and non-amyloidosis group (n=30). (1) Amyloidosis deposition was observed in amyloidosis group. (2) HE staining was used to compare changes of inflammatory cells in two groups. (3)PAS staining was used to observe polysaccharide difference in two groups. (4)Values of serum hemoglobin (HGB), white blood cell count (WBC), lymphocyte absolute value (LYM), neutrophil absolute value (NEU), total protein (TP), albumin (Alb) and prealbumin (PA) were com?pared between two groups. Results (1)Leiomyoma entity cells were negatively Congo red stained, while 5 out of 6 pseudo-capsule fiber deposition and 2 out of 6 blood vessel were positively Congo red stained. (2)Infiltrations of inflammatory cells were observed in two groups. (3) The PAS positive staining was found in amyloidosis deposition and non-amyloidosis deposi?tion groups. (4)There were no significant differences in HGB, WBC, NEU, LYM, TP, Alb and PA levels between two groups (P>0.05). Conclusion Metabolism changes resulted from cell function alterations in local micro-environment by uterine leiomyoma may be related to the formation of the amyloidosis.

Objective To investigate whether there is amyloid fibers in the mature neutrophils and to reveal the molecular mechanism of the formation of AD amyloidosis. Method Thirty cases of AD patients and 30 healthy control were enrolled. The white blood cell, the red blood cell,hemoglobin and neutrophil absolute value were determined by Sysmex X5-500i hematology analyzer. The neutrophils and amyloid variable specific probe affinity were measured, The starch like variable fluorescence intensity in plasma was dtected by the sulfur T (Thioflavin T, ThT) method. Results The affinity test results showed that the amyloidosis fluorescent probe (ThT) can be combined with tissue amyloid fibers specifically. The neutrophil amyloid fibers staining also showed a positive reaction. Compared with the AD group, no significant differences were found in white blood cell, red blood cell, hemoglobin and neutrophil absolute value level in the healthy control group The serum amyloid variable fluorescence intensity in the AD group was significantly higher than that in the control group (P < 0.05). Conclusion The amyloid fibers was found in the mature neutrophils, and the level of plasma amyloid fibers was significantly increased in the AD patients.

Objective To compare the clinical efficacy and fusion rate of unilateral and bilateral C1 and C2 pedicle screw fixation of unstable Jefferson fractures.Methods This retrospective casecontrol study enrolled 22 patients with unstable Jefferson fractures admitted between April 2012 and May 2015.There were 18 males and four females,with the mean age of 52.9 years (range,35-67 years).Mean preoperative visual analogue scale (VAS) was 6.09 points (range,4-8 points).According to the American spinal injury association (ASIA) classification,two patients were rated grade D and one patient grade C.Mean Japanese orthopedic association (JOA) score was 12.3 points.Bilateral C1 and C2 pedicle screw fixation was performed for 15 patients (bilateral group).Advantage side unilateral C1 and C2 pedicle screw fixation was performed for seven patients with extremely unstable fracture or narrow pedicle (unilateral group).Operation time,blood loss and surgical complications were recorded.VAS was used to evaluate the improvement of neck pain after operation.ASIA classification and JOA score were used to assess nerve function recovery.Atlanto-dental interval (ADI),srew position and bone fusion were evaluated after operation.Results All patients successfully completed the operation.Operation time was (119.5 ±21.2)min,and blood loss was (280.1 ±83.1)ml.A total of 74 screws were placed and CT scan showed satisfactory position of the screws.No complications were noted either during the operation or after surgery.All patients were followed up for mean 20.7 months (range,13-33 months).VAS was improved in both groups after operation (P ＜ 0.01),and there was no significant difference between the two groups (P ＞ 0.05).Two patients with ASIA grade D in bilateral group were improved to ASIA grade E after operation.One patient with ASIA grade C in unilateral group was improved to ASIA grade D after operation.JOA score increased to mean 15.7 points at last follow-up.ADI were decreased in both groups after operation(P ＜0.05),but there was no significant difference between the two groups (P ＞ 0.05).All patients had bony fusion 6 months after operation,with similar fusion rate between the two groups (P ＞ 0.05).Conclusion Advantage side unilateral screw fixation can be used for the patients with bilateral C1 and C2 pedicle screw fixation failure,for the technique can improve cervical pain and provide relatively high stability and fusion rate.

Objective To compare the clinical effects of posterior pedicle screw fixation combined with anterior monosegmental or bisegmental fusion reconstruction in patients with unstable Denis type B thoracolumbar burst fractures.Methods A retrospective case-control analysis was made on 62 cases of Denis type B thoracolumbar burst fractures treated from June 2010 to June 2014.There were 51 males and 11 females,aged 19-55 years (mean,35.1 years).The injury causes included fall from height in 32 cases,traffic accidents in 24,hit by heavy objects in 6.Fifty cases were with monosegmental burst fractures,and 12 with monosegmental burst fractures combined with other vertebral compressive fractures.The burst fracture levels were at T~in 8 cases,T12in 20,L1 in 24,L2 in 6,and L3 in 4.According to the different surgical methods,the patients were divided into two groups:Group A (n =30,treated with posterior pedicle screw fixation combined with anterior monosegmental fusion reconstruction) and Group B (n =30,treated with posterior pedicle screw fixation combined with anterior bisegmental fusion construction).The operation time and intraoperative blood loss were compared between the two groups.Visual analogue scale (VAS),Oswestry disability index (ODI),and Frankel scale of neurologic function were compared at last follow-up.The changes of anterior height of fracture vertebrae and Cobb angle of the two groups were also compared preoperatively,postoperatively and at last follow-up.Implant looseness and breakage,titanium mesh tilt,and bone fusion were recorded postoperatively.Results All patients were followed up for 18-24 months (mean,20.8 months).The operation time and blood loss in Group A was (208.2 ± 15.6) min and (598.3 ± 55.3) ml,respectively.The operative time and blood loss in Group B was (260.1 ± 17.4)min and (662.2± 58.3)ml,respectively.There were significantly statistical differences between two groups in operation time and blood loss (P ＜0.05).There were no statistical differences between two groups in terms of Cobb angle restoration and fracture height restoration rate after surgery,Cobb angle loss and fracture vertebral body front height loss rate at final follow-up (P ＞ 0.05).At the final follow-up,VAS in Group A was (2.5 ± 0.8) points,less than (3.2 ± 1.1) points in Group B (P ＜ 0.05);ODI in Group A was (20.3 ± 5.8) points,less than (28.2 ± 5.1) points in Group B (P ＜ 0.05).Frankel scale was improved to some degree after operation (P ＜ 0.05).One case did not achieve bone fusion in Group A versus three cases in Group B (P＜0.05).No implant Loosening,titanium mesh tilt or settlement was found in Group A,while there were eight cases of titanium mesh tilt or settlement in Group B (P ＜0.05).Conclusions For unstable Denis type B thoracolumbar burst fractures,posterior pedicular fixation combined with anterior monosegmental fusion or bisegmental fusion can achieve equal clinical effects.However,posterior pedicular fixation combined with anterior monosegmental fusion can have less injury,higher bone fusion rate,better function restoration,and less incidence of complication.

Objective To investigate the clinical efficacy of posterior lumbar interbody fusion and internal fixation for the treatment of lumbar spinal stenosis with redundant nerve roots (RNRs).Methods A retrospective case series study was performed on the clinical data of 23 cases of lumbar spinal stenosis with RNRs from January 2009 to December 2014.This study involved 10 males and 13 females,with an average age of 48.4 years(range,38-58 years).The course of disease averaged 28.1 months(range,2 months-7 years).There were seven patients with single segment of stenosis,12 patients with two segments of stenosis,and four patients with three segments of stenosis.RNRs diagnostic criteria:in the sagittal section of the MRIT2 image of lumbar spine,the cauda equina nerve root in the dural sac was circular,tortuous and twining.MRI information was collected and analyzed by three double-blind radiologists,respectively.RNRs were determined based on the unanimous consent of all the three doctors.All patients underwent posterior discectomy,spinal canal decompression,interbody fusion,and internal fixation after admission.The operation time,intraoperative blood loss,and postoperative complications were recorded.The visual analogue scale (VAS),Oswestry disability index (ODI),and Japanese Orthopedic Association (JOA) score were used to evaluate the back pain and leg pain before operation and 3 months after operation.Fischgrund standard was used for the overall efficacy evaluation.Results All patients were followed up for 12-30 months (mean,23.3 months).The operation time was (130.0 ± 23.2) minutes,and the intraoperative blood loss was (513.0 ± 165.0) ml.MRI was reviewed 1 week after operation,and the result showed that redundancy of cauda equina disappeared.Preoperatively,the scores of back pain VAS,leg pain VAS,ODI and JOA were (6.3± 0.8) points,(6.8 ±0.9)points,(46.7±2.5)points and (10.3 ±2.8)points,respectively.At 3 months postoperatively,the scores were (1.4 ± 0.5) points,(1.8 ± 0.7) points,(11.9 ± 2.1) points,and (25.3 ± 1.8) points,respectively (P ＜ 0.05).In terms of the efficacy,17 cases were excellent,four good,and two fair,with an excellent and good rate of 91％.At 12 months after operation,the CT scan showed no screw rupture or cage dislocation,with bony union seen between the vertebrae.Conclusion Posterior lumbar interbody fusion and internal fixation can help relieve the back and leg pain and eliminate redundant nerve roots in patients with lumbar spinal stenosis with RNRs.