Objective To study the efficacy and safety of short segmental pedicle instrumentation via the paraspinal approach for the management of neurologically intact patients with thoracolumbar burst fracture and posterior ligamentous complex injury.Methods From October 2008 to June 2010,70 such patients were treated in our department.They were 44 males and 26 females,with an average age of 33.4 years (range,from 19 to 55 years).They were divided into 2 groups according to 2 different operative methods.In group A,35 patients were treated via the paraspinal approach while 35 patients in group B were treated via the traditional open approach.The 2 approaches were compared in terms of operation time,intraoperative bleeding,postoperative ambulant time,hospital stay,changes in local kyphosis angle (LKA) and vertebral body height (VBH) at preoperation,postoperation and the last follow-up,postoperative complications and accuracy of screw insertion.Results The time for follow-up ranged from 24 to 36 months (mean,29.3 months).The operation time,intraoperative bleeding,postoperative ambulant time and hospital stay in group B were significantly more than in group A(P ＜ 0.05).No implant failure occurred in either group.There was no significant difference in pedicle screw cut-out between the 2 groups [7 (5.0％) versus 6 (4.3％)] (P ＞0.05).The LKA and VBH increased significantly at postoperation and the last follow-up compared with the preoperation in both groups (P ＜ 0.05),but there was no significant difference between the postoperation and the last follow-up (P ＞ 0.05).There were no significant differences between the 2 groups regarding LKA and VBH at preoperation,postoperation and the last follow-up (P ＞ 0.05).Conclusion The paraspinal approach may result in a good and safe clinical outcome in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury,because it can maintain the fracture reduction effectively and minimize the iatrogenic injury to soft tissues.

Objective To explore the method of correctly placing and fixing mesh plug and patch in tension-free hernioplasty. Methods The data of 123 cases of plug-mesh tension-free hernioplasty with the method of placing and fixing mesh plug and patch were reviewed. Observed the incidence of postoperative effusion, infection, sinus formation, skin flap necrosis and hernia recurrence. Results All patients were restored after operation 8 days. Followed-up 1.5 -10.0 years,there was no incision effusion, infection,skin flap necrosis in all cases. No relapse happened on the operated side and 5 cases of inguinal hernia occurred on the non-operated side. Conclusions Mesh plug and patch must be placed to cover the whole abdominal wall defects,and contact closely with surrounding healthy tissue. They need to be placed neatly,fixed firmly and perpetually without any damage to the normal tissue structure.

Objective To explore the influence of dose rate reference control level on the design of accelerator shielding.Methods According to the standards of GBZ 126-2011,GBZ/T 201.1-2007 and GBZ/T 201.2-2011,two different shielding calculation methods,based on the dose rate reference control level and week dose control level,were used to calculate and compare the thickness of accelerator room shielding.Results Under the same condition of maximum weekly workload,the obtained results were different when the calculated dose rate reference control value was larger than dose rate reference control level (2.5 μSv/h).The maximum difference of shielding thickness reached 64 cm.Meanwhile,considering dose rate reference control level,the different accelerator rates could lead to different radiation shielding thickness.Conclusions The dose rate at reference point must be first calculated before calculating shielding thickness.The calculation should be made on the premise that dose rate reference control level is met.

A gas chromatographic analysis method was employed to determine the cellular fatty acids (CFAs)profiles of the spores of some aerobic endospore4orming bacilli. Purified spore cultures of 51 experimentas strains were processed to acquire whole cell fatty acids methyl esters for the subsequent gas chromatographic analysis,and the corresponding vegetative cells were set as control. The reproducibility study of spore fatty acids revealed that,the fatty acids components of spores were stable enough for research purpose,provided under standardized experimentas procedure. The dendrograms obtained by cluster analysis provided some meaningful taxonomic information of the experimental strains. The fatty acids analysis of spores seemed to be a promising supplementary tool for the chemotaxonomic research of aerobic endospore-forming bacilli.

Objective To investigate the value of strain rate imaging(SRI) in estimating the changes of left ventricular regional myocardial function in patients with coronary artery disease before and after coronary artery bypass grafting operation. Methods In sixteen patients with coronary artery disease, echoeardiography was performed 3 days before, 12 days after and 3 months after coronary artery bypass grafting operation respectively. SRI was used to quantitatively analyze the regional myocardial function of left ventricular wall. One hundred and ninety-two segments of left ventricular myocardium were analyzed in the study. The left ventricular myocardium was divided into segments with normal(152 segments) and abnormal(40 segments) wall motion according to two-dimensional echocardiography before the operation. Results Peak strain rate during systolic and early diastolic contraction (SRs, SRe) was not statistically significant between segments with normal and abnormal wall motion before operation. In segments with abnormal wall motion,myocardial peak strain rate of atrial contraction (SRa) was increased three months after operation comparing with three days before operation (P<0.05). In segments with normal wall motion,the absolute values of SRs,SRa and SRe were increased three months after operation comparing with three days before operation (P<0.05 and 0.01 ). SRs was increased three months after operation comparing with 12 days after operation (P<0.05 ). Conclusions SRI can be used to evaluate the functional changes of left ventricular regional myocardium quantitatively after coronary artery bypass grafting operation.

A gas chromatographic analysis method was employed to determine the cellular fatty acids (CFAs)profiles of the spores of some aerobic endospore forming bacilli.Purified spore cultures of 51 experimentas strains were processed to acquire whole cell fatty acids methyl esters for the subsequent gas chromatographic analysis,and the corresponding vegetative cells were set as control.The reproducibility study of spore fatty acids revealed that,the fatty acids components of spores were stable enough for research purpose,provided under standardized experimentas procedure.The dendrograms obtained by cluster analysis provided some meaningful taxonomic information of the experimental strains.The fatty acids analysis of spores seemed to be a promising supplementary tool for the chemotaxonomic research of aerobic endospore-forming bacilli.

Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.

Objective To assess the value of primary resection and anastomosis with intraoperative colonic defecation in the patients with obstructive left colonic cancer. Methods From January 2000 to January 2008, 39 patients undergoing emergency laparotomy for left colonic cancers with complete obstruction were analyzed retrospectively. Results The patients were 25 males and 14 females, with a median age of 68.5 years (range: 57～78 years). The primary tumors were located at splenic flexure (3/7.7%), descending colon (8/20.5%), sigmoid colon (15/38.5%), boundary of sigmoid colon and rectum (8/20.5%), and superior segment of rectum (5/12.8%). Primary resection and anastomosis with intraoperative colonic de-fection were performed in 18 patients with left hemicolectomy, 13 patients with sigmoid colectomy and 8 pa-tients with anterior resection. Early complications included wound infection in 4 patients (wound disruption in 1 patient) and pulmonary infection in 5 patients. One patient complicated with anastomotic leakage and intra-abdominal abscess died of tumor metastasis after reoperation. Another one died of respiratory failure secondary to pulmonary infection. Morbidity and mortality was 25.6% and 5.1% respectively. Conclusion Primary resection with intraoperative colonic defecation can be applied to patients with malignant colonic complete obstruction with good operative results.

Objective:To explore the mechanism of cardiac function decreasing in patients with ankylosing spondylitis based on Keap1-Nrf2-ARE signaling pathway .Methods:Experiment group included 140 ankylosing spondylitis ( AS) patients and control group included 60 healthy individuals .Echocardiography ( UCG) was used to detect cardiac function parameters .Enzyme-linked immunosor-bent assay(ELISA) was adopted to determine serum proteins ,oxidative stress indicators and cytokines .Erythrocyte sedimentation and plasma C reactive protein ,immunoglobulin were detected with Westergren method and Hitachi 7060 automatic biochemical analyzer re-spectively.Results:(1)Compared with the normal control group , character of AS group in active stage:cardiac function parameters(E peak,EF,E/A),antioxidant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)decreased (P<0.01 or P<0.05 all).A peak, Keap1,Nrf2,oxidation index(ROS,RNS,MDA),cytokines(IL-1,TNF-α),inflammatory indicators(ESR,CRP)increased(P<0.01 or P<0.05 all).(2)Compared with the normal control group, character of AS group in stable stage: cardiac function parameters(E peak,E/A),Keap1,antioxidant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)decreased (P<0.01 or P<0.05 all).A peak, Nrf2,oxidation index(ROS,RNS,MDA),cytokines(TNF-α),inflammatory indicators(ESR,CRP) increased(P<0.01 or P<0.05 all).(3)Compared with AS group in stable stage , character of AS group in active stage:cardiac function parameters(E peak,EF,E/A),antioxidant indicators(SOD,TAOC),cytokines(IL-10)decreased (P<0.01 or P<0.05 all).Keap1,Nrf2,oxidation index(ROS, RNS,MDA),cytokines(IL-1β,TNF-α),inflammatory indicators(ESR,CRP),clinical evaluation indicators (VAS,BASDAI,BASFI, BASMI,BAS-G)increased(P<0.01 or P<0.05 all).(4)Compared with AS patients with normal Keap1 or Nrf2 of peripheral blood, A peak increased while E peak and E/A decreased in AS patients with abnormal Keap1 or Nrf2 of peripheral blood (P<0.01 or P<0.05).(5)Spearman correlation analysis showed:AS parameters of cardiac function in patients with E peak and antioxidant indicators (SOD,CAT,TAOC),cytokines(IL-4,IL-10)showed significant positive correlation.E peak and Keap1, Nrf2,oxidation index(ROS, RNS,MDA),cytokines(IL-1β,TNF-α),inflammatory indicators(ESR,CRP),clinical evaluation indicators (VAS,BASDAI,BASFI, BASMI,BAS-G),IgG,course of the disease were significantly negatively correlated .A peak and Nrf2,oxidation index ( ROS,RNS, MDA) ,cytokines ( IL-1β,TNF-α) ,clinical evaluation indicators , Palpitation showed significant positive correlation .A peak and antiox-idant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)were significantly negatively correlated .E/A and Keap1,antioxidant indi-cators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)showed significant positive correlation.E/A and oxidation index(ROS,RNS, MDA) ,cytokines ( TNF-α) ,cxcinical evaluation indicators ,course of the disease were significantly negatively correlated .EF and course of the disease were significantly negatively correlated .FS and Keap1 showed significant negative correlation .Conclusion:Cardiac func-tion decreasing in patients with ankylosing spondylitis is 33.56%.The characteristic performance is that E peak , E/A decreased while A peak increased.E peak,E/A and antioxidant indicators ,anti-inflammatory cytokines show significant positive correlation .E peak,E/A and Keap1,oxidation index,pro-inflammatory cytokines,inflammatory indicators are significantly negatively correlated .A peak and Keap1,oxidation index ,pro-inflammatory cytokines show significant positive correlation .A peak and antioxidant indicators ,anti-inflam-matory cytokines are significantly negatively correlated .The rising of Keap1 expression cause activate the Keap 1-Nrf2-ARE signaling pathway .After the signaling pathway is activated ,the body's antioxidant ability decreased , pro-inflammatory cytokines imbalanced , in-flammation index increased .When the body is long be in unbalance condition , the number of abnormal immune complex deposition in-creased.In the end,the result is that AS is caused and cardiac function is decreased .

Objective:To investigate the expressions and clinical significances of SMO , STAT3 and MMP-9 in triple negative breast cancer ( TNBC) .Methods:The expressions of SMO , STAT3 and MMP-9 were immunohistochemically detected in 33 cases of TNBC, 30 cases of mammary hyperplasia and 18 cases of normal breast tissue , and the relationships among SMO , STAT3 and MMP-9 and clinicopathological parameters and prognosis of TNBC patients were analyzed .Results:In TNBC and mammary hyperplasia tissue , the positive expression rates of SMO were 90.9%and 60.0%,the positive expression rates of STAT3 were 96.9% and 73.3%, the positive expression rates of MMP-9 were 90.9% and 36.7%, respectively, however, expressions of them were completely absent in normal breast tissue .The significant correlations were observed between expressions of SMO , STAT3 and MMP-9 in TNBC, mammary hyperplasia and normal breast tissue (P<0.05).The expression of SMO and STAT3 was correlated with superior histologic grade and tumor stage .The expression of MMP-9 was correlated with metastasis of lymph node .The positive correlation was manifested between SMO and STAT3(r=0.361,P<0.05),between SMO and MMP-9 (r=0.633,P<0.01),between MMP-9 and STAT3 (r=0.803,P<0.01) in TNBC.The survival time of TNBC patients was correlated with SMO expression and pTNM (P<0.05).Conclusion:SMO, STAT3 and MMP-9 may play important roles in development of TNBC and may be an important therapeutic target in TNBC .