BACKGROUND:Because it can reduce the risk of postoperative bone cement leakage, percutaneous kyphoplasty is increasingly used for treatment of severe osteoporotic thoracolumbar vertebral compression fractures. Studies have found that injection of mixed bone cement with high viscosity can significantly reduce the leakage of bone cement. OBJECTIVE:To compare the therapeutic efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with standard viscosity bone cement in the treatment of severe osteoporotic thoracolumbar vertebral compression fractures. METHODS:Eighty patients with severe osteoporotic thoracolumbar vertebral compression fractures were enroled and randomized into vertebroplasty group and kyphoplasty group, 40 patients in each group. Visual analog scale score and Oswestry disability index score were compared between groups before and after treatment. Incidence rate of bone cement leakage and other complications were also compared between two groups after treatment. RESULTS AND CONCLUSION:No significant difference was found between the visual analog scale scores of two groups after treatment (P> 0.05). Patients in the two groups al presented with good recovery of spinal function after treatment, and there was no difference in the Oswestry disability index scores between groups at 3 months after treatment (P> 0.05). The incidence rate of bone cement leakage was 45% in the vertebroplasty group and 30% in the kyphoplasty group, with a significant difference (P < 0.05). But the patients in both groups showed no obvious clinical symptoms and underwent no treatment. After treatment, al patients had no pulmonary embolism, bone cement toxicity, spinal cord and nerve root injury. These findings show that there is no significant difference between percutaneous vertebroplasty and kyphoplasty with high-viscosity bone cement in the folowing aspects: pain improvement, recovery of the spinal function, incidence rate of bone cement leakage and clinical efficacy.

Objective To evaluate the clinical significance of colonoscopy in the diagnosis of pathological changes of terminal ileum.Methods The clinical characteristics of terminal ileum,endoscopic manifestations and pathological results of 72 cases were retrospectively summarized.Results 72 cases of terminal ileum lesions diag-nosed with terminal ileum 32 cases,28 cases of lymphoid follicles hyperplasia,polyps in 5 cases,crohn's disease (3 cases),intestinal tuberculosis in 1 case,lymphoma in 1 case,small intestinal carcinoma in 1 case,terminal ileum bleeding in 1 case.Conclusion Colonoscopy is the first choice for diagnosis of terminal ileum diseases and effective method,for early diagnosis and treatment of terminal ileum diseases have important clinical significance.

Objective: To investigate the significance of laminin(LN) and laminin receptor(LN-R) in the proceeding and prognosis of hydatidiform mole.Methods: Immunohistochemical SP staining was used to detect the expression of LN and LN-R in 41 hydatidiform mole cases(13 cases were learned to have turned malignant by following up).20 cases of normal early gestational chorion were detected as control.Results: The strong positive rates of LN and LN-R in normal chorion,hydatidiform mole un-malignant group and malignant group were respectively 90.0%(18/20),71.4%(20/28),38.5%(5/13),and 70.0%(14/20),71.4%(20/28),84.6%(11/13).The strong expression of LN had a significant difference between malignant group and the other 2 groups(P

Objective To explore the etiology of abdominia incision hernia and treatments of giant incisional hernia of abdominal wall. Methods 14 cases with AGIH treated in our hospital from Oct 2003 to May 2008 were analyzed retrospectively. Results The etiology of abdominia incision hernia were very important,and abdominal longitudinal incision was performed, 10 cases ＞ 67y among 14 cases with incision hernia were 71.42%. Infection of incision and essential conditions( diabetes, chronic cough ,hypoalbum inemia)were also easily induced of incisional hernia. All of them chose the marlex patch. The cases were all cured and no serious postoperative complications. None of cases recurred during a follow up of 3 to 56 months. Conclusion The etiology of AGIH related with longitudinal incision,old ( ＞ 60y)and essential conditions. AGIH were repained with polypropylene mesh. Essential conditions should be treated before operation and abdominal wall should be trained comfortablely. Repairing abdominal incision hernial with artifical patch was a safe and simple operation with minimal postoperation pain.

The constitutional medical thoughts in Inner Canon of Huangdi is the foundation for TCM constitution theory, it discusses the influence of constitution on disease in detail. Constitution factors determine the disease onset or not; Constitution factors determine the tendency and character of disease. Constitution factors effect the changes of pathogenesis, the character of syndrome, the therapeutic principle and methods; Constitution factors effect the turnover and prognosis. Constitution therapies are profit to correct the partial body, preventing the development of disease and heal the disease.

Objective To investigate the application value of intraoperative ultrasound (IOUS) in living donor liver transplantation(LDLT). Methods In LDLT, IOUS techniques (gray scale ultrasound and color Doppler flow imaging) were adopted in 26 donors and recipients for parenchymal and vascular examinations. The abnormal sonograms were observed, and the anatomic findings of hepatic veins were recorded. All the reanastomosed blood vessels were examined by gray scale ultrasound and color Doppler flow imaging before the operations were completed. Results A hepatic parenchymatous tumor was revealed by IOUS in one donor. Besides, middle hepatic veins in 13 donors and secondary hepatic veins with diameter﹥0.5 cm in 5 donors were confirmed by IOUS. Furthermore, one operation procedure was changed and one hepatic artery stenosis was established according to IOUS findings. Conclusion IOUS is a very useful means in evaluation of parenchymal and vascular conditions of donors and recipients in LDLT, which helps to select the best cross section and provides evidence for the change of surgical procedures.

High intensity focused ultrasound (HIFU)is a new technology of focal therapy for patients with hepatic carcinoma.Comparing with operation and other focal therapeutic methods (such as radiofrequency and transcatheter arterial chemoembolization) of liver cancer,HIFU is non-invasive,accurate,and definite in killing the tumor tissue with fewer complications.Thus,it is widely accepted in clinical settings and has a promising prospect.In this article,we review the mechanism and present situation of hepatic carcinoma therapy with HIFU and dicuss some clinical application and development in the future.

As an important branch of system biology,metabolomics is an emerging discipline following with genomics,proteomics and transcriptomics,which studies the variety of endogenous and exogenous metabolites in physiological or pathological state.With the rapid development of technology,metabolomics has been widely used in clinical researches.

To explore the relationship between clinical findings and pathological changes of IgA nephropathy (IgAN), 37 children with IgAN were undertaken clinical classification and renal-pathological comparison including glomerulus change, renal tubule-interstitial change and immunopathology. The results showed that there were 18 (49%) cases with hematuria, 14 (38%) cases with nephrotic syndrome, 3(8%) cases with both of hematuria and proteineuria, and 2 (5%) cases with nephritic syndrome in the clinical classification. 54% of cases with glomerulus changes was as class III. No significant relationship was found between clinical classification and glomerulus changes. There were 24 cases with renal-tubule interstitial changes and 7 cases with hematuria. 43% of them were classified as class I and 57% as class II.All cases with nephrotic syn-drome developed renal tubule-interstitial change. 78% (11 cases) of them were as class II and 22% (3 cases) as class III. Besides, 2 of 3 cases with both of hematuria and proteineuria and 1 of 2 cases with nephritic syndrome also manifested renal tubule-interstitial change. There were four phenotypes were observed in immunopathology including 16 cases of them as IgA, 6 cases as IgAG, 10 cases as IgAM and 5 cases as IgAGM, respectively. 66% of cases with hematuria was found as IgA and 50% of cases with nephrotic syndrome as IgAM. It is concluded that hematuria can be a main clinical finding in both of IgAN and nephrotic syndrome. Glomerulus changes is usually not correlated with clinical classification. There is a significant renal tubule-interstitial change in cases with nephrotic syndrome. Hematuria is usually as IgA and nephrotic syndrome as IgAM in immunopathology.

Modern pharmacogenomics demonstrates that genetic polymorphisms account for the most important factor of adverse drug reactions and interindividual variations of drug therapy. Personalized medicine aims to choose the appropriate drugs and dosage for increasing the efficacy and safety with minimal adverse effects based on the patients' genotypes. This article introduce the progresses in pharmacogenomics in China, discusse many factors that influence the application of personalized medicine from bench to bedside, and highlighted the challenges and further development of this field in the future.