Objective To compare the short-term clinical effect of K-Rod pedicle dynamic fixation system and lumbar fusion for multi-ple segmental lumbar degeneration.Methods Between January 2010 and October 2012,56 patients with segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system and posterior lumbar interbody fusion were retrospectively reviewed.The 56 patients were divided into K-Rod and fusion group,28 patients with K-Rod pedicle dynamic fixation system and 28 cases with traditional lumbar fusion and internal fixation.Clinical assessments were based on comparion of Oswestry disability index score ,visual analogous scale (VAS),im-provement rate of low back pain,postoperative lumbar spine X-ray,average operation time and intraoperative blood loss of two groups.Results All of 56 cases were followed up for 12 to 24 months,the difference of Oswestry disability index score and VAS between two groups were not statistically significant(P >0.05),but the difference of average operation time,blood loss and the average length of stay(ALOS)were statis-tically significant(P <0.05),the K-Rod group was superior to the fusion group.Conclusion In the treatment of multiple segmental lumbar degeneration both K-Rod pedicle dynamic fixation system and traditional lumbar fusion can obtain satisfactory short-term clinical effect,but the K-Rod pedicle dynamic fixation system has advantages of less intraoperative blood loss,shorter operation time,postoperative small effects on lumbar spine mobility.

Objective To investigate the FYES and FYX allele expression situation of Duffy blood group in Han population of Nanjing area.Methods The genomic DNA was randomly extracted from peripheral EDTA-K2 anticoagulation blood samples in 200 voluntary blood donors and Duffy blood group FYA and FYB allele typing was performed by PCR-SSP.The EYES and FYX allele sequence charateristics of Duffy blood group were analyzed by adopting Sanger double deoxygenation gene sequencing method.Results The PCR genotyping results were consistent with the sequencing results.Among 200 samples,180 cases were FYA/FYA and 20 cases were FYA/FYB;the sequencing results showed that FYES and FYX allele expression was not been found in 200 samples.Conclusion The expression frequencies of FYES and FYX alleles are extremely low in Han population of Nanjing area,which has significant difference compared with other races.

Objective To investigate the expression levels of regulator of G-protein signaling 4 (RGS4) in pediatric nephroblastoma and pericancerous tissues, and explore the relationship between RGS4 and the occurrence and development of pediatric nephroblastoma. Methods Thirty-seven samples of pediatric nephroblastoma tissues and 8 samples of pericancerous tissues were collected after surgery to detect the expression of RGS4 protein by immunohistochemistry. Another 8 samples of fresh cancer tissues and corresponding pericancerous tissues were collected to detect the mRNA and protein levels of RGS4 by qRT-PCR and Western blot assay, respectively. Results Immunohistochemistry results showed that RGS4 protein was positively expressed both in pediatric nephroblastoma and pericancerous tissues, and its high expression rate was lower in pediatric nephroblastoma than that in pericancerous tissues [(37.83%(14/37) vs. 87.5%(7/8),χ2=4.675, P<0.05]. The expression level of RGS4 mRNA was significantly lower in pediatric nephroblastoma than that in pericancerous tissues (1.064 ± 0.549 vs. 5.374 ± 0.735, t=13.290, n=8, P < 0.01). Western blot results showed that the expression level of RGS4 protein was lower in pediatric nephroblastoma than that of pericancerous tissues (0.301±0.092 vs. 0.779 ± 0.041, t=13.424, n=8, P < 0.01). Conclusion The expression level of RGS4 is down-regulated in pediatric nephroblastoma, which may be related to the occurrence and development of pediatric nephroblastoma.

Objective To observe the clinical curative effect of phentolamine in the treatment of severe hand-foot-mouth disease (HFMD) . Methods We observed the clinical symptoms and related index changes before and after treatment of 62 cases of severe HFMD patients who were treated by the basis of conventional therapy with additional phentolamine. The blood pressure of patients was closely monitored,and the dosage of phentolamine was adjusted. Result The blood pressure and heart rate of sick children who used phentolamine improved significantly, the difference was statistically significant ( <0.05) . Conclusion Phentolamine has significant clinical curative effect in treatment of server HFMD.

AIM: To establish a model of subtotal nephrectomy (SNx) and investigate the changes of apoptosis and apoptosis-related genes (Bax, bcl-2, caspase-3, caspase-8 and caspase-9) in the rat remnant kidney. METHODS: Remnant kidneys were produced in adult male SD rats by 5/6 nephrectomy. The renal function and histopathological changes were evaluated at 1, 2, 4, 8, 12, 16, 26 and 40 weeks after operation. The tissues of remnant kidneys were collected to detect apoptosis cells by in situ end-labeling of cleaved DNA (TUNEL) and proliferating cells by determining the proliferating cell nuclear antigen (PCNA). The expression of Bax, bcl-2, caspase-3, caspase-8 and caspase-9 was measured by RT-PCR and Western blotting. The proteins were detected by immunohistochemistry staining. The relation between apoptosis, proliferation, glomerulosclerosis and renal interstitial fibrosis was also observed. RESULTS: The results showed the renal pathological dynamic changes in 5/6 nephrectomy remnant kidneys were tubule-interstitial inflammation and fibrosis, as well as glomerulosclerosis. There were transient increases in both proliferating and apoptotic processes in glomerulus, tubules and interstitium. Apoptosis was increased and most of apoptotic cells were detected in tubular epithelial cells and interstitial area. The mRNA and protein expression of Bax, caspase-3, caspase-8 and caspase-9 were increased in all course, and peaked at week 4 and 40 in the SNX rats. The successive changes of these parameters were parallel to the level of focal inflammation in interstitium. Glomerulosclerosis index was related with focal inflammation cells and 24 hours urine protein (r=0.788, 0.822; P

The molecular descriptors of impurities with known structure in cefdinir were calculated, selected and associated with the chromatographic retention behavior to establish a model. This quantitative structure retention relationships (QSRR) model for the related substances of cefdinir was established under specific chromatographic condition and verified by other impurities. 12 molecular descriptors were used to establish the QSRR model, F_AFRBWF, Blbn_J, SsCH3, SssCH2, SsNH2, SssNH, SssS, SHdCH2, EEM_AFc, EEM_AFpl, EEM_XFpl and Pi_MaxQ. The relativity between true values and predictions in QSRR of cefdinir is R2 = 0.9836 (n = 18), ΔRRT is no more than 0.154, as 10.17% in RRT. The results indicate that the QSRR model for the related substances of cefdinir can be used to evaluate the analysis methods for related substances and predict the chromatographic behavior of new impurities, which will provide a new way for the evaluation of the effectiveness for drug quality control.

Objective To discuss the short-term clinical effect of K-Rod pedicle dynamic fixation system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,28 patients with multiple segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system were retrospectively reviewed. The short-term clinical effect were based on Oswestry disability index score,visual analogous scale ( VAS) ,improvement rate of low back pain,postoperative lumbar hyperextension, hyperbend X-ray film lumbar ROM value ( lumbar flexion mobility) ,average operation time, intraoperative blood loss. Results All of 28 cases were achieved 12 ~24 months follow-up,the difference of Oswestry disability index score and visual analogous scale ( VAS) between 12 months postoperatively and preoperatively were statistically significant,the improvement rate of low back pain was (87. 0 ± 2. 0)%,the average operation time was (99. 6 ± 16. 2) minutes,the average blood loss was (70. 5 ± 31. 5)mL,the average length of stay(ALOS) was (11. 2 ± 2. 6) days after sur-gery. Conclusion K-Rod pedicle dynamic fixation system in the treatment of multiple segmental lumbar degeneration can obtain satisfactory short-term clinical effect.

Objective To discuss the clinical effect and the notes of atlas lateral mass screws combined with posterior epistropheus ped-icle screws for the treatment of atlantoaxial joint instability. Methods In our hospital from January 2006 to January 2011,48 cases of atlan-toaxial joint instability accepted operation of the atlas lateral mass screws combined with epistropheus pedicle screws were analyzed. Results All patients with follow-up time 12~24 months,an average of 17 months,were achieved primary healing and atlanto-axial intervertebral osse-ous healing. Besides postoperative neck pillow area pain improved and nerve function get a degree of recovery,there was no inner fixed damage cases. Complications of operation include venous plexus hemorrhage was in 2 cases,cervical occipital pain and numbness increase in 3 cases,cere-brospinal fluid leak in 2 cases,vertebral artery extrusion occlusion after cerebral ischemic symptoms in 1 case. Conclusion Combination of atlas lateral mass screws and posterior epistropheus pedicle screws technique is one of the effective means of treatment of atlantoaxial joint instabili-ty and can obtain satisfactory clinical effect. Standard operation performance is the key to reduce or even eliminate surgical complications.

Objective To investigate dynamic changes of plasma D-dimer, C-reactive protein (CRP) and fasting plas?ma glucose (FBG) levels in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type 2 diabetes mellitus. Methods AECOPD group (n=65) was used as A group, AECOPD combined with type 2 diabetes mellitus group (n=65) was used as B group. Levels of D-dimer, CRP and FBG were observed and compared between two groups in the first day, the 3rd day, the 7th day and the 14th day after hospital admission. The correlation be?tween D-dimer, CRP and FBG was analyzed. Logistic regression analysis was used to estimate the factors affecting increased plasma levels of D-dimer. Results Levels of D-dimer, CRP and FBG were significantly higher in B group than those of A group in the first day, the 3rd day, the 7th after hospital admission (P<0.01). Values of D-dimer and CRP were declined ob?viously in A group in the 7th day after hospital admission, but in B group they were declined obviously until the 14th day. There was no significant difference in FBG of A group. The level of FBG was significantly decreased in B group. There was a positive correlation between D-dimer, CRP and FBG (P<0.05). Logistic regression analysis showed that CRP, FBG, p(O2) and age were the influence factors for the increased levels of D-dimer. Conclusion In elderly patients with AECOPD com?bined with type 2 diabetes mellitus, we should pay attention to anti-inflammatory and controlling blood sugar, and the dy?namic monitoring levels of D-dimer, which helps to improve the prognosis for patients with AECOPD, and reduce mortality.

Objective To observe the effects of parathyroidectomy(PTX) on bone metabolism and bone mineral density(BMD) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT).Methods A total of 26 dialysis patients with SHPT were treated with PTX.Serum calcium,phosphorus,alkaline phosphatase(ALP) levels were determined by standard methods.The levels of serum intact parathyroid (iPTH),osteocalcin (OC),procollagen type Ⅰ aminoterminal propeptide (PINP),β-crosslaps (β-CTX) were measured by chemiluminescence.BMD was measured by dual energy X ray absorptiometry.iPTH,OC,PINP,β-CTX,serum calcium,phosphorus,ALP were measured before parathyroidectomy and 1,3,6,12,18,24 months after operation.Lumbar spine (LS) and femoral neck (FN) BMD were measured before and 24 months after PTX.Results Compared with that before operation,serum OC[(104.49±25.42) μg/L vs (695.46±355.62) μg/L,P ＜ 0.01] and PINP levels [(248.36 ± 159.38) μg/L vs (809.28 ± 283.50) μg/L,P＜ 0.01] progressively decreased 3 months after PTX,and serum β-CTX levels [(1.60±0.64) μg/L vs (3.37±1.34) μg/L,P ＜ 0.01] decreased 1 month after PTX.Compared with that before operation,BMD levels increased 24months after PTX in LS[(0.88±0.23) g/cm2 vs (0.78±0.23) g/cm2,P ＜ 0.01] andFN[(0.96±0.19) g/cm2 vs (0.84±0.24) g/cm2,P ＜ 0.01],and Z-scores were also increased in both LS[(-1.24±0.55) vs (-1.66± 0.24),P ＜ 0.01] and FN[(-1.51 ±0.72) vs (-1.93 ± 0.40),P ＜ 0.01].Correlation analysis showed that baseline iPTH was positively correlated with ⊿Z-score in FN (r=0.584,P=0.002) and LS (r=0.400,P=0.043),and so did the OC with ⊿Z-score in FN (r=0.651,P ＜ 0.001) and LS (r=0.509,P=0.008).Conclusion The levels of OC,PINP and β-CTX are reduced and BMD is improved in hemodialysis patients with SHPT after PTX.