Objective To observe the effects of hydrocortisone on the rate of return of spontaneous circulation(ROSC)and the outcome of patients with cardiac arrest(CA)and cardiopulmonary resuscitation(CPR). Methods A cohort study was conducted,78 non-traumatic patients with CA were divided into hydrocortisone group (31 cases)and control group(47 cases). Conventional treatments were given in the two groups after admission,and additionally intravenous 100 mg hydrocortisone was given to the hydrocortisone group during resuscitation. The ROSC rate and prognosis were compared between the two groups. Multivariate logistic regression analysis was used to predict the impact factor of ROSC. Results The ROSC rate and 24-hour survival rate in the hydrocortisone group were significantly higher than those of the control group(ROSC rate:58.1% vs. 40.4%,24-hour survival rate:48.4%vs. 36.2%,both P<0.05). There were no significant differences between the hydrocortisone and the control groups in duration of CPR〔minute:17.1(6-45)vs. 15.8(7-48)〕,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in survivors(37.2±8.2 vs. 36.1±8.2),the survival rate(12.9% vs. 12.8%)and hospital discharge rate(6.4%vs. 6.4%)in 7 days. Hydrocortisone〔odds ratio(OR)=3.12,95%confidence interval(95%CI)-1.18-8.29, P=0.017〕and witness(OR=4.24, 95%CI -1.87-12.43,P=0.008) were independent predictors for an increased ROSC rate after multiple logistic regression analysis. Conclusion Giving hydrocortisone during resuscitation may increase ROSC rate in CA patients.

Objective To study the effect of parenteral nutrition combined with chemotherapy on nutritional status and immunity function of patients with gastrointestinal cancer.Methods 100 gastrointestinal cancer patients were treated as research subjects,and they were randomly divided into the treatment group and the control group.The control group was not given special treatment during chemotherapy,while the observation group patients were given nutritional support according to the gastrointestinal function after admission.The nutrition indicators of ALB,TF,PA, immune function parameters IgA,IgG,IgM,T lymphocyte subsets and T cell immune function indicators(CD +4 ,CD +8 and CD +4 /CD +8 )were counted after the four courses.Results There was no significant difference between the preop-erative and after fourth courses of treatment(t =0.093,P >0.05)between the two groups in nutrition.Within group comparisons,data of Tf and PA levels in the observation group were significant different compared with the control group after fourth courses of treatment (t =3.302,P <0.05).After the first 4 postoperative course,IgM index was statistically significant(t =4.135,P <0.05)different between the two groups,three indicators within the observation group were higher than the preoperative level indicators,the difference was statistically significant(t =3.426,P <0.05).After the first 4 postoperative course,the CD +4 level was significantly higher in the observation group,the difference was statistically significant(t =0.087,P <0.05).Comparison between the two groups after the first four courses,the CD +4 /CD +8 level was higher than that of preoperative patients with a significant difference(t =3.359,P <0.05).Intra -group comparison of the control group,four courses of CD +8 was significantly lower than that of the pre-operative patients(t =3.265,P <0.05).Conclusion Parenteral nutrition combined with chemotherapy can improve the nutritional status of patients with malignant tumors of alimentary tract and improve the body's immune function, give parenteral nutrition support treatment and provide a theoretical basis for the digestive tract malignant tumor during chemotherapy.It is worthy of clinical popularization.

Objective To study the effect of parenteral nutrition combined with chemotherapy on immune function in patients with digestive tract malignant tumor. Methods One hundred patients with digestive tract malignant tumor were selected, and they were divided into the observation group and the control group by random digits table method with 50 cases each. The patients in control group during chemotherapy did not receive special treatment, and the patients in observation group were given parenteral nutrition support according to the gastrointestinal function during chemotherapy. The nutrition index, immune function index and T lymphocyte subsets after treatment were observed. Results The transferrin, prealbumin, IgA, CD4+and CD4+/CD8+levels after treatment in observation group were significantly higher than those in control group: (2.41±0.53) g/L vs. (2.15±0.57) g/L, (0.28±0.07) g/L vs. (0.20±0.08) g/L, (3.25±1.19) g/L vs. (2.85±1.01) g/L, 0.403±0.065 vs. 0.323±0.083 and 2.15±1.02 vs. 1.35±0.73, while the IgM in observation group was significantly lower than that in control group: (1.02 ± 0.35) g/L vs. (1.48±0.78) g/L, and there were statistical differences ( P<0.05). There were no statistical differences in body weight, albumin, IgG, and CD8+between 2 groups (P>0.05). Conclusion Parenteral nutrition combined with chemotherapy can improve the immune function in patients with digestive tract malignant tumor, and provide a theoretical basis for the treatment of parenteral nutrition combination with chemotherapy.

To investigate the diagnosis and surgical treatment of inraspinal tumors.
The clinical data of 246 patients with inraspinal tumors who had undergone operations in the Affiliated Hospital of Qingdao University Medical Col ege between January 2010 and January 2013 were retrospectively analyzed. The treatment and prognosis of inraspinal tumors were reviewed.
262 operations were performed, with posterior bilateral laminectomy approach in 202 cases, semi-laminectomy approach in 28 cases, laminoplasty approach in 10 cases, and lateral resection of extra-vertebral canal dumbbel shaped tumors in 22 cases. The short-term remission rate of the nerve root pain reached 95.0%(133/140), and the improvement rates of the sensory disability, motor disturbance, and sphincter dysfunction were 85.6%(125/146), 86.7%( 136/157), and 84.6(11/13) respectively. The ASIA nervous function scores and grades at the last fol ow-up were significantly superior to those before and 3 months after the operation in 236 patients.
Intraspinal tumors are mostly benign. The clinical appearance of them should be watched closely, and thorough physical check-up should be performed. MRI is the examination of choice at early diagnosis. The key to improve the treatment effects is to perform operations as soon as possible.

Objective To study the precision of computer-aided preoperative templating for total hip arthroplasty. Methods Thirty patients (11 males, 19 females; age ranged from 42 to 85 years, mean 56 years) received unilateral total hip arthroplasty from March 2008 to December 2008. Preoperative tem-plating was done with LINK -Preop-PlanTM to compare the size of the planned hip joint with the size of the prosthesis, as well as the discrepancy of the limbs before and after operation. Results The predicted sizes of the prosthesis corresponded well with the actual ones. The cup size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 8 patients (27%) and ≥2 sizes in 3 patients (10%). The stem size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 9 patients (30%) and ≥2 sizes in 2 patients (7%). The variation of the cemented and cementless stem size of the prosthesis was within 1 size in 16 patients (89%) and 12 patients (100%), respectively, with no statistical difference (P > 0.05). The discrepancy of limb length was (9.0±8.5) mm preoperatively and (1.1±2.4) mm postoperatively. Conclusions Preoperative planning is of paramount significance in total hip arthroplasty. Computer-ai-ded preoperative templating can accurately anticipate the type of the prosthesis, which is helpful in correc-ting the discrepancy in leg length.

BACKGROUND: Inhibiting the degradation of extracellular matrix in the intervertebral disc can delay the degenerative process of intervertebral disc. Matrix metalloproteinases-3 (MMP3) is considered as a key enzyme for degradation of extracelular matrix components such as type II collagen and aggrecan.
OBJECTIVE:To construct the short hairpin RNA lentiviral vector targeting human MMP3 gene and to detect its efficiency of gene silence by infecting human degenerative nucleus pulposus cells.
METHODS:According to the human MMP3 mRNA (NM_002422.4) sequence, four groups of the short hairpin RNA gene sequences targeting MMP3 were designed, synthesized and annealed to form double stranded DNA fragments, which were connected with the LV3 vectors digested by BamHI andEcoRI enzymes, and then transfected into the competent cels. The positive clones were identified by PCR, and analyzed by sequencing. The packaging and titer of lentivirus were determined after transfecting 293T cells. Human degenerative nucleus pulposus cels were infected with lentivirus vector, and the transfection efficiency of each group was observed under inverted fluorescence microscope. The interfering efficiency was detected by real time-PCR and western blot at 72 and 96 hours.
RESULTS AND CONCLUSION:The ds-oligo DNA was successfully inserted into the lentiviral vector as confirmed by electrophoresis and sequence analysis. The recombinant lentivirus was harvested from 293T cels with a viral titer of 1-5 ×108 TU/mL. RNA interference targeting the GCC AGG CTT TCC CAA GCA AAT sequences with the highest interfering efficiency in MMP3 gene at 72 and 96 hours resulted in suppression of MMP3 mRNA expression by 98% and 72%, respectively; and at 96 hours, the interfering efficiency of protein expression was 57.2%. The recombinant lentivirus vector containing RNA interference targeting MMP3 gene is successfuly constructed, which lays a foundation for further studies on the MMP3 function and gene therapy.

The explosive growth and advancement of computer science in recent decades have prompted the rapid development and wide applications of imaging techniques in life science, which have brought about revolutionary changes in modern medicine. Nowadays, it is possible to visualize multiple physiological and disease processes, precisely and non-invasively, in a living human body. Modern medicine has even started"reading the mind", to diagnose psychology, behavior and degenerative disorders of human brain. The border between the organic and inorganic diseases in old dogma is disappearing because imaging techniques have"visualized"the neurological and tissue changes of inorganic disorders. Severe burn injury is associated with very complicated pathological processes, which are always at the borderline between life and death. Complete recovery of patients with severe burn injury, if possible, may take years of time. Hence, a real-time monitoring of the disease process is of pivotal importance in early recognition and prevention of life-threatening complications and in assessing the therapeutic efficacy for a less-eventful recovery. Here we review and introduce some potential applications of modern imaging techniques in burn care and research, which may benefit burn patients. Some techniques are still in their early or pre-clinical stage and some are mature techniques in other fields of medicine, which are potentially applicable in burn diagnosis and treatment through our research. We intend to bring your interest to this field which may eventually lead to new revenues improving our clinical work on burn victims.

BACKGROUND: As the preliminary experiment for gene therapy in intervertebral disc degeneration, this study aims to construct a recombinant plasmid containing fluorescent pAAV-hSOX9-IRES-tdTomato for adeno-associated virus packaging, in a broader attempt to lay the foundation for late experiments in vitro and in vivo.OBJECTIVE: To construct human SOX9 gene overexpressing adeno-associated virus, pAAV-hSOX9-IRES-tdTomato, packaging. METHODS: The plasmid pAAV-IRES-tdTomato and plasmid pUC57-hSOX9 were connected into pAAV-hSOX9-IRES-tdTomato by enzyme digestion method. The adeno-associated virus was packaged with plasmid co-transfections method. The recombinant pAAV-hSOX9-IRES-tdTomato was transfected into 293AAV cell by calcium phosphate transfection. The purification and drop of adeno-associated virus was tested by determination of biological titer. RESULTS AND CONCLUSION: The results of BLAST sequence comparison analysis showed that, pAAV-hSOX9-IRES-tdTomato exactly matched the synthetic gene sequence hSOX9. The titer is 1×107 TU/mL. Human gene SOX9 recombinant adenoviruses, pAAV-hSOX9-IRES-tdTomato, have been constructed successfully.

Objective To retrospectively evaluate and analyze the clinical effect of posterior pedicle subtraction osteotomy in treating chronic, posttraumatic thoracolumbar kyphosis. Methods Nineteen patients (11 males and 8 females) with chronic, posttraumatic thoracolumbar kyphosis were corrected surgically. The patients were at age range of 29-61 years (mean 42 years). Preoperative kyphosis Cobb angle ranged from 31° to 63° (mean 47°) and trauma history ranged from 8 months to 63 months (mean 29 months). All patients were treated with pedicle subtraction osteotomy according to the size of Cobb angle, extent of spinal stenosis and source of compression. Results Sagittal alignment was improved to average 40.2°, with a correction rate of 85.8%. Two patients developed postoperative leakage of cerebrospinal fluid. Among them, one was combined with encephalic infection and cured with active treatment, and the other developed postoperative wound infection, which were treated conservatively with antibiotics and local wound care. There were no other severe complications. The average follow-up period was 15 months (range 6-41 months). At the last follow-up, clinical symptoms and neurological function were improved significantly. Neither loss of correction nor failure of internal fixators was observed. X-ray and dynamic X-ray films showed a 100% fusion in all patients. Conclusions The single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. It is possible and safe to obtain a correction within 55° on single segment by this technique.

Objective To observe the sensitization of lidocaine on subcutaneous hepatoma H22-bearing mice and abdominal cavity H22 tumor-bearing mice treated by mitomycin. Methods According to the random number table method, the mice were divided into subcutaneous tumor-bearing group and abdominal cavity tumor-bearing group, with 15 mice in each group. The mice in the two groups were further divided into three subgroups: model group, mitomycin group, mitomycin+lidocaine group, with 5 mice in each subgroup. The day before the intraperitoneal injection, the density of H22 cells obtained from peritoneal culture of one mouse was adjusted to 5 ×106/ml. Subcutaneous tumor-bearing group mice were injected H22 cells into the right armpit, and abdominal cavity tumor-bearing group mice were injected H22 cells into the abdominal cavity, 0.2 ml per mouse. Intraperitoneal injection was given after inoculation for 24 h (the experiment day 1), followed by intraperitoneal injection on day 5 and 9. Univariate ANOVA analysis and t test were used to analyze the solid tumor weight and tumor inhibition rate on the 11th day of subcutaneous tumor-bearing mice, and the survival time and life extension rate within 60 days of abdominal cavity tumor-bearing mice. Results The solid tumor weight of subcutaneous tumor-bearing mice model group, mitomycin group and mitomycin + lidocaine group were (3.77 ±1.02) g, (1.67 ±0.28) g, (0.74 ±0.19) g, respectively, and the differences in the three groups were statistically different (F = 31.753, P < 0.01); compared with the subcutaneous model group, the subcutaneous solid tumor weights of mitomycin group and mitomycin +lidocaine group were decreased and the differences were both statistically different (t=2.10, P<0.01; t=3.04, P<0.01); the subcutaneous solid tumor weight of mitomycin+lidocaine group was lower than that of mitomycin group (t= 0.93, P= 0.034). The tumor inhibition rate of mitomycin group and mitomycin +lidocaine group reached 55.70％ and 80.37％ respectively. The survival time of abdominal cavity tumor-bearing mice in model group, mitomycin group and mitomycin + lidocaine group was (16.80±0.84) d, (28.80± 6.30) d, (40.40±12.86) d, respectively, and the differences in the three groups were statistically different (F=10.155, P=0.003); compared with the abdominal cavity tumor-bearing mice model group, the survival time of mice in mitomycin group and mitomycin + lidocaine group was prolonged (t= 12.00, P= 0.041; t= 23.60, P= 0.001), and it was found that survival time in mitomycin + lidocaine group was longer than that in mitomycin group (t=11.60, P=0.047). The life extension rate of mitomycin group and mitomycin+lidocaine group reached 71.43％ and 140.48％ respectively. Conclusion Lidocaine can increase the sensitization of mitomycin on hepatoma H22-bearing mice.