Objective To study the expression of CXCL12 and E-cadherin in condyloma acuminatum (CA) lesions caused by low-risk type (HPV6 and HPV11) humanpapilloma viruses. Methods The expressions of CXCL12 and E-cadherin mRNA in the lesions of CA caused by HPV6 and HPV11 and in the foreskins from normal males as controls were detected by real-time fluorescent quantitative PCR. Results The expressions of CXCL12 in the lesions of CA were down-regulated (fold change = 20.23,P = 0.001), and the expressions of E-cadherin were up-regulated (fold change = 3.129,P > 0.05). Conclusions The expression of CXCL12 is lower and the expression of E-cadherin is higher in the lesions of CA caused by low-risk HPV. It suggests that HPV may suppress local immune response and change the adhesion between langerhans cells and keratinocytes , which may contribute greatly to the persistent infection of HPV and relapse of CA.

Objective To discuss total vertebrectomy and spine stability and reconstruction by pos-terior ap proach for thoracic vertebra tumor and pedicle screw system fixation and intervertebral fusion.Methods Eighteen patients of 3males and15females of thoracic total vertebral tumor were operated in this group.The age of the group were from14to58years old,with the average of 23years.There were4aneurysmal bone cysts,2hemangiomas,2osteoblastomas,1neurilemomas,5giant cell tumor,1solitary myeloma and3metastatic thoracic vertebra tumors.The locations of the tumors was T 4 in1case,T 5 in1case,T 6 in2cases,T 8 in4cases,T 9 in3cases,T 10 in4cases,T 11 in2cases and T 12 in1case respectively.Pre-operative Frankel classification was grade A in6cases,B in7cases,C in3cases and E in2cases.Cir-cumferential decompression was performed with total spondylectomy through one-stage posterior ap proach.Anterior verte bral reconstruction was provided by autograft(ribs or ilium)bone or metallic cage;Posterior reconstruction was achieved by pedi cle screws system of CD or TSRH,Scofix fixation and auto graft fusion.Results The mean follow-up was8months,ranging from3months to24months.Twelve of 16cases with neu ro logical dysfunction were recovered completely,1case recovered from Frankel grade A to C,2cases from grade A to D,1case from grade B to D.The patient with neurilemmoma recurred and became ma lig nant after20months of operation and died4months later.One case of metastatic tumor of lung cancer sur vived6months after opera tion.One patient with giant cell tumor recurred.The other patients were still alive in the latest follow-up.There were no instruments breakage and spinal instability during the follow-up.Conclusion If the thoracic total vertebral tumor compress spinal cord se riously,the patients should be indi cat-ed for surgical treatment constructively.Total vertebrectomy followed by one-stage posterior approach re con-struction could relieve the com pression caused by tumor and reconstruct the stabilization of spine effectively.

Objective The aim of this study is to examine the effect of myoophenolate mofetil (MMF) on epithelial-myofibroblast transiation(EMT) in adenine-induced chronic renal failure (CRF) rat model and the role of vascular endothelial growth factor(VEGF) and inhibitor of differentiation (Id2 and Id3) in EMT in the rat kidney. Methods Sixty-four male Wistar rats were randomly assigned to the following groups: normal control (n=16), CRF (n=24) and MMF(n=24). CRF was induced by gastric gavage of adenine (125 mg·kg-1·d-1) to rats for eight weeks. CRF rats were treated with MMF (15 mg·kg-1·d-1) as "MMF" group. The rats were sacrificed at week 2, 4, 6 and 8, respectively.Urinary protein and serum ereatinine levels were measured, and the histopathologic degrees of interstitial fibrosis were evaluated in Massen-stained sections. Expressions of a-smooth muscle actin (α-SMA),transforming growth factor β1 (TGFβ1), VEGF and Id (Id2 and Id3) in the kidney tissue were assessed by immunohistochemistry, RT-PCR and/or Western blot methods. Results The urinary protein level in MMF group was evidently lower than that in CRF group (P<0.01), whereas no statistically significant difference was observed in serum creatinine level between the two groups. Renal interstitial fibrosis was reduced significantly with MMF treatment (P<0.01). Expression of α-SMA in MMF group was lower than that in CRF rats at week 6, 8 (P<0.01), while expression of TGFβ1 was decreased markedly at week 2, 4,6 (P<0.01). The expressions of VEGF in MMF rats were increased significantly at week 6,8 (P<0.01),and Id2,Id3 in MMF rats were increased significantly at week 4,6 (P<0.05). Conclusions MMF may ameliorate chronic renal fibrosis and EMT in adenine-induced CRF rats. This effect of MMF on EMT is probably related to upregulation of VEGF, Id2 and Id3 expressions and suppressing overexpression of TGFβ1 in renal tissue. The exact mechanism needs to be studied further.

Objective To evaluate the clinical effect of thoracic discectomy via trans-facet-joint approach in the treatment of thoracic disc herniation.Methods Thirty-three cases were included in this group from October 1994 to August 2009.There were 27 males and 6 females.The age ranged from 18 to 72 years old,with an average of 41.8 years.The course of disease ranged from 12 days to 36 months and was lesser than one month in 13 cases.The weakness and numbness of lower limbs occurred after trauma in 9 cases.Fifteen cases were diagnosed as simple thoracic disc herniation.Six cases were associated with ossification of posterior longitudinal ligament and 12 cases were associated with ossification or hypertrophy of yellow ligament.A total of 45 discs were involved,including 32 in lower thoracic segments(71.11%),8 in upper thoracic segments(17.78%)and 5 in middle thoracic segments(11.11%).All the herniated discs and the ossified OPLL were excised via the trans-facet-joint approach.For the cases with ossification or hypertrophy of yellow ligament,the laminectomy and replantation were performed.The screw-rod system was used on both sides in 14 cases,on one side in 19 cases.Results Follow-up was acquired in 27 patients,ranged from 12 to 63 months(mean,37 months).According to Epstein and Schwall grade,there were excellent in 15 cases,good in 10 cases,improved in 2 cases and poor in 2 cases.The excellent and good rate was 86.21% and total effective rate was 93.10%.Postoperative complications occurred in 3 cases,including exacerbation of preexisting deficits in 2 cases and implant failure in 1 case.The former 2 cases were treated with methylprednisolone,dehydrant,neural nutrition and hyperbaric oxygen.One patient had recovered to preoperative level,the other had not recovered to the preoperative level.The implant was removed 18 months after operation for the implant failure.The post-operative CT or MRI showed that all the replanted lamina obtained fusion,and the canal decompression was complete.Conclusion Thoracic discectomy via trans-facet-joint approach can improve the clinical result obviously.

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.

To investigate an approach of treatment for atrial fibrillation with discrete ablation lesion, 12 dogs with experimental atrial fibrillation underwent radiofrequency catheter ablation. Atrial lesion was made at the most vulnerable site. The results showed that in 10 of 12 dogs persistent fibrillation could be ablated. There was no significant change in sinus heart rate, P wave duration, and corrected sinoatrial node recovery time (cSNRT). The results suggested that paroxysmal atrial fibrillation could be eliminated by point ablation of the lesion, and that trigger activity might be involved in the mechanism of atrial fibrillation.

According to the current situation of the medical ethics education,much emphasis should be put on strengthening the practicalness of medical ethic education;to achieve this goal,the following aspects should be guaranteed: to combine the medical ethic education tightly with medical practices;to face all the difficulties and exert every means to work out the ethical issues emerged from the medical and healthy practice;to impart ethical education to professional curriculum,especially the course of clinical field work.

Objective To establish the standard for the quality control of Yubo Shaoshang Spray.Methods The identification of Rhizoma Polygoni Cuspidati and Cortex Phellodendri in Yubo Shaoshang Spray were carried out by TLC.The content of emodin in the preparation was determined by HPLC.Chromatographic column was adopted,methanol-0.1 %H3PO4 (85 ∶15) was used as the mobile phase,flow rate 0.80 mL/min, column temperature at 40℃and detection wavelength at 254 nm.Results The TLC spots were highly clear without the interference of negative control and were reproductive.The calibration curve for emodin was linear(r=0.9993) in the range of 0.1～0.5 ?g and the mean recovery rate was 99.34 %and RSD=1.33 %(n=5).Conclusion This method is simple and accurate for the quality control of Yubo Shaoshang Spray.

Objective To establish a RP- HPLC method for the determinatio n of protocatechualdehyde in Danqi tablet. Methods LiChrospher RP- 18 column w as used, the mobile phase was MeOH- 1.5 % Hac(1∶ 9) with a flow rate of 1.0 mL/ min, and the detection wavelength was at 280nm. Results There was a goo d linearity within the range of 0.030～ 0.150 ? g of protocatechualdehyde. The average recovery was 103.08 % and RSD was 0.796 % (n=5). Conclusion This method can be used for the quality control of Danqi tablet .

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.