Objective To discuss the operative efficacy of anterior- and postero-decompression plus pedicle screw instrumentation through posterior approach in the treatment of thoracolumbar burst fractures. MethodsFrom February 2006 to November 2009,28 patients with thoracolumbar burst fracture and spinal cord injury were treated with anterior-and postero-decompression plus pedicle screw instrumenattion through posterior approach.They were 19 men and 9 women,21 to 52 years of age (average,35.6 years).The fractures happened at T11 in 3 cases,at T12 in 11 cases,at L1 in 9 cases and at L2 in 5 cases.By AO classification,there were 16 cases of type A3,7 cases of type B and 5 cases of type C.By the ASIA(American Spinal Injury Association) system,6 cases were rated as grade A,12 cases as grade B and 10 cases as grade C. Bone grafting was performed according to different conditions of the patients.Results The patients were followed for 12 months to 24 months,with an average of 14 months.The X-ray examinations showed that the mean anterior border height of the injured vertebrae recovered from46.8％ ± 18.3％ of the normal height before operation to 90.3％ ± 14.2％ postoperatively; the mean posterior border height recovered from preoperative 80.4％ ± 12.4％ to postoperative 94.2％ ± 15.1％ ; and the mean cobb angle decreased from preoperative 20.1°± 11.5° to postoperative 2.7°± 2.4°. The differences between preoperation and postoperation were significant(P ＜ 0.05).According to the ASIA evaluation system,neurofunctional recovery was achieved in the cases of incomplete paralysis except in the 6 eases who had had complete spinal cord injury of Grade A. Conclusion Anterior- and posterro-decompression plus pediclescrew instrumentation through posterior approach is an effective method of treating thoracolumbar burst fractures.

Objective To ratiocinate the formula of relationship between opening size of laminoplasty and the increment of sagittal canal diameter following double-door cervical laminoplasty and to predict the increment of sagittal canal diameter and the cross sectional area of canal according to the opening size of laminoplasty.Methods Twenty patients (12 males and 8 females) with multilevel cervical spondylotic myelopathy had undergone double-door cervical laminoplasty (C3-C7 in 9 patients and C3-C6 in 11 patients,89 segments) in our institution between September 2010 and January 2013.The formula describing the relationship between the opening size of laminoplasty and the increment of sagittal diameter was deduced.The parameters of pre-and post-operative computed tomography scans of 20 patients who had undergone laminoplasty surgery were measured by picture archiving and communication system (PACS) software,and the increment of sagittal canal diameter and the cross sectional area of canal were predicted when the opening size of laminoplasty were 6 mm,8 mm,10 mm,12 mm,14 mm and 16 mm according to the formula.Results Increment of sagittal canal diameter and canal area respectively showed significant difference in the same segment laminoplasty.Increment of sagittal canal diameter between various groups in the same segment (C3-C6) showed significant difference.Increment of sagittal canal diameter between the opening size of 14 mm and 16 mm in C7 laminoplasty showed no significant difference.Increment of sagittal canal diameter was increased steadily following C3-C7 double-door laminoplasty with opening sizes of 6 mm,8 mm,10 mm,12 mm,14mm and 16mm,but the increasing trend in sagittal canal diameter diminished gradually.Conclusion Increment of sagittal canal diameter and canal area following C3-C7 laminoplasty can be accurately predicted according to the opening size of laminoplasty by this formula.The formula can help operator to perform double-door cervical laminoplasty based on accurate individual laminoplasty opening size,which prevents inadequate or excessive opening.

Objective To study the clinical pathological characteristics and prognostic factors of carcinosarcoma in corpora uteri.Methods Clinical data of 17 corpora uteri carcinosarcoma patitents diagnosed in Jining Medical University from June 2008 to December 2013 were analyzed.Results In 17 cases of uterine sarcoma,I had 3 cases, 4 cases of stageⅡ,8 cases of stage Ⅲ,and 1 case of stage Ⅳ.The overall survival rates of the 3 years and stage Ⅲ ~Ⅳ were 62.5% and 11.1%,respectively.The 3 -year survival rate was 100.0%,and the 5 -year survival rates of stageⅠ ~Ⅱ,Ⅲ ~Ⅳ were 37.5%,0.0%,respectively.Univariate analysis showed that the staging influenced the prognosis.Conclusion The prognosis of patients with uterine sarcoma is related to the surgical pathologic stage.

Objective:To investigate the correlation between the methylation and expression of Runt associated transcription factor 2 (RUNX2) gene in peripheral blood and sensitivity to neoadjuvant chemotherapy in breast cancer.Methods:90 female breast cancer patients who received full-course neoadjuvant chemotherapy and surgical resection for the first time in our hospital from Jan. 2021 to Jun. 2022 were included as the study objects, and 90 healthy women who underwent physical examination in our hospital during the same period were included as the control group. The methylation level of RUNX2 gene in peripheral blood of all subjects was detected by sulfite conversion method, and the mRNA expression level of RUNX2 gene in peripheral blood was detected by fluorescence quantitative PCR. The effects of neoadjuvant chemotherapy in breast cancer patients were divided into sensitive and insensitive groups.Results:The positive rate of RUNX2 gene methylation in peripheral blood of breast cancer patients was 41.11% (37/90) , significantly lower than that of the control group (64.44% (58/90) , the difference was statistically significant ( χ2=9.830, P=0.002) . The mRNA expression level of RUNX2 gene in peripheral blood of breast cancer patients was 1.73±0.24, which was significantly higher than that of the control group (1.19±0.18) , and the difference was statistically significant ( t=5.221, P<0.001) . The mRNA expression level of RUNX2 methylation-positive patients in peripheral blood of breast cancer patients was 1.26±0.20, significantly lower than that of RUNX2 methylation-negative patients (1.84±0.26) , and the difference was statistically significant ( t=4.981, P<0.001) . The positive rate of RUNX2 gene methylation was 49.28% (34/69) in patients with sensitivity to neoadjuvant chemotherapy, significantly higher than 14.29% (3/21) in patients with insensitive chemotherapy, and the difference was statistically significant ( χ2=8.142, P=0.004) . The mRNA expression level of RUNX2 gene in peripheral blood of neoadjuvant chemotherapy sensitive patients was 1.62±0.17, which was significantly lower than that of insensitive patients (2.09±0.22) , and the difference was statistically significant ( t=5.283, P<0.001) . The ROC curve showed that the sensitivity and specificity of RUNX2 mRNA expression in peripheral blood to predict the effect of neoadjuvant chemotherapy were 85.7% and 85.5%, respectively. Conclusion:The methylation and expression level of RUNX2 gene in peripheral blood are related to the sensitivity of neoadjuvant chemotherapy in breast cancer, and can be used as a marker to predict the efficacy of neoadjuvant chemotherapy in breast cancer.