Objective To determine the efficacy of vertebroplasty and kyphoplasty with polymethylmethacrylate (PMMA) and carbonated hydroxyapatite cement (CHC) as augmenting biomaterials in the treatment of osteoporosis vertebral compression fractures subsequent to osteoporosis. Methods 58 patients of osteoporosis with vertebral compression fractures were treated with the following methods: vertebroplasty+PMMA (11 cases, 13 vertebra), vertebroplasty+CHC (23 cases, 26 vertebrae), kyphoplasty+PMMA (8 cases, 8 vertebrae), and kyphoplasty+ CHC (16 cases, 19 vertebrae). The height loss and kyphotic angle of vertebral compression fractures were respectively measured from preoperative and postoperative lateral X-ray films, and with them the restored height ratio and kyphosis angle ratio were calculated. Both preoperation and postoperation pain scores were evaluated by Visual Analog Scale (VAS). Results No complication was found in all the patients. The restored ratio of both vertebra heights and kyphotic angles by kyphoplasty was better than that by vertebroplasty. There was no difference of filling volume in all the groups. The operation time of vertebroplasty was significantly shorter than that of kyphoplasty. There was no difference in preoperative VAS scores. The VAS scores of PMMA groups were better than that of CHC groups, but the difference was not obvious 4 weeks after operation. Conclusion Vertebral augmentation was a minimally invasive, safe and effective method for the treatment of osteoporosis vertebral compression fractures in patients with osteoporosis. The treatment modality and filling biomaterials should be selected according to the patients' condition.

ObjectiveTo investigate the ultrasonic clinical value of scalpel in abdominal surgery for D2 radical gastrectomy for gastric cancer.MethodsA retrospective analysis was made in Zhengzhou University Affiliated Luoyang Central Hospital from September 2008 to September 2010 gastric group.The patients were divided into ultrasound knife group and normal operative in 136,including 75 cases using ultrasonic scalpel,61 using cases electric knife.The lymph node dissection time,intraoperative blood loss,the drainage 72 h after were compared between the two groups.Results The average operation time ultrasound knife group was ( 114 ± 35 ) min,the surgery blood loss was ( 110.4 ± 32) mL.The drainage 72 h after operation was (180 ± 24) mL,which were significantly reduced compared with the normal operative group.The difference in detection rate between the two groups was not statric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastri cancer.ConclusionsUltrasound knife used in D2 radical gastrectomy for gastric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastric cancer.

Objective To study the protein expression and gene amplification of human epidermal growth factor receptor-2(Her-2)in adenocarcinoma of the gastroesophageal junction and its association with the clinicopathological features .Methods Immunohistochemical method and fluorescence in situ hybridization ( FISH) were used to detect Her -2 expression and gene amplification in 80 surgically resected gastroesophageal junction cancer tissue .We further analyzed the relationship between the gastroesophageal junction cancer histolog -ical differentiation ,as well as depth of invasion ,clinical stage and lymph node metastasis .Results Her-2 am-plification of gastroesophageal junction carcinoma by FISH was 22.5%,while the overexpression by IHC was 15%.Her-2 gene amplification and protein overexpression were correlated with the differentiation ,clinical TNM stage,invasive depth and lymph node metastasis of the carcinoma (all P<0.05).Her-2 expression was not asso-ciated with the patients age,gender,invasive depth and lymph node metastasis(P<0.05).Conclusion Her -2 protein expression and gene amplification may be a prognostic indicator for the patients with gastroesophageal junction cancer .The joint detection of Her -2 protein expression level and the gene amplification can guide the prognosis and therapy for adenocarcinoma of the gastroesophageal junction .

0.05,thus a fixed effect model was applied.As compared with the control group,kakkonein in-jection has a higher total effective rate with the odds ratio at2.05and95%confidence interval at1.10～3.82(P

Objective To assess the value of contrast-enhanced ultrasound(US)in differential diagnosis of hyperechoic hepatic lesions when compared to conventional US.Methods Eighty-four hyperechoic liver lesions in 66 patients were examined using both conventional and contrast-enhanced US techniques.Results Receiver operating characteristic analysis revealed a significant improvement in the discrimination of malignant versus benign hyperechoic hepatic lesions (area under the receiver operating characteristic curve,0.867±0.045 at conventional US,0.997±0.003 with contrast-enhanced US(P＜0.0001).For correct diagnoses types of hyperechoic liver lesions,contrast-enhanced US improved from 64.3% to 92.9%,comic)ared with conventional US (P＜0.001).Conclusions Contrast-enhanced US showed a significant improvement in characterization and differentiation of hyperechoic hepatic lesions when compared to conventional US.

BACKGROUND: Carbonated hydroxyapatite cement (CHC) s a new kind of biomaterial for bone defect, which is made of powder and fluid, and can be mixed to be pasty to repair various bone defects.OBJECTIVE: To observe the improvement of vertebrae height and pain in patients with osteoporosis vertebral compression fracture (VCF) after vertebroplasty by using a new kind of bone graft biomaterial, taking CHC as the filling material to reinforce the vertebral body.DESIGN: A contrast observation trial taking patients as subjects.SETTING: Department of Orthopaedics, General Hospital of Chinese PLA.PARTICIPANTS: Totally 34 patients with thoracic or lumbar osteoporosis VCF who received the treatment in the Department of Orthopaedics, General Hospital of Chinese PLA between October 2000 and August 2003. Inclusive criteria: ①Definite diagnosis by CT; ② Informed consents were obtained from the patients. Exclusive criteria: The patients with osteoporosis vertebral compression fractures who suffered vertebral posterior wall fracture. There were 6 males and 28 females, and they were aged (72±13)years; Among the patients, 27 were diagnosed as postmenopausal osteoporosis, 1 as cortical hormone-induced osteoporosis and 6 male patients weresenile osteoporosis.METHODS: ①All the patients were randomly divided into two groups: Experimental group (n =23) and control group (n=11). All the patients were performed percutaneous operation with local anesthenia. All cases were performed percutaneous operation under local anesthesia. Under the C-arm monitored, one side pedicle puncture was performed to enter the anterior column of the involved VCF. Patients of the experimental group were filled with CHC. Patients of control group were filled with polymethyl Methacrylate (PMMA) with the same way. ② Referred to McGill-Melzack scoring. Among the scale 0-100 mm (0 was no pain, 100 was acute pain), the value indicated the painful intensity and mental assault degree. ＜ 30 scores indicated good, 30-40 basically satisfied and ≥ 50 poor .③ Referred to the method from Lee et al, the preoperative height (A1) and postoperative height (A2) of compression fracture position of VCF were measured according to the lateral X-ray film. At the same time, the upper vertebral height (A3) and the inferior vertebral height (A4) were measured at the same position. The original height (A) of the involved vertebra was calculated as (A)= (A3+A4)/2,and the preoperative vertebral compression rate =(A-A1 )/A, the postoperative vertebral compression rate =(A-A2)/A, the restoring rate = (the preoperative vertebral compression rate-the postoperative vertebral compression rate)/the preoperative vertebral compression rate. ④ The wounds of the patients were observed after operation. The levels of blood routine, serum calcium and serum phosphorus were detected before, one day and one week after operation. MAIN OUTCOME MEASURES: ① Preoperative and postoperative VAS scoring. ② The vertebral compression rate and restoring rate. ③ Wounds were observed after operation. The blood routine, the serum calcium and serum phosphorus were detected before, one day and one week after operation.RESULTS: Totally 34 patients were involved in the result analysis. ①The preoperative visual analogue scale (VAS) score of experimental group were (91.5±21.7) points, and the postoperative ones were (44.5±27.2) points. The difference of VAS score reduced gradually along with the postoperative time. There was no difference of VAS score between experimental group and the control group 4 weeks after operation. ② The biocompatibility of CHC in the vertebral body was fine. The vertebral compression rate of experimental group was recovered from (43.1±21.4)％ preoperatively to (27.3± 18.5)％ postoperatively. The rate of restored heights was (27.3±18.5)％. ③ All patients obtained Ⅰ stage wound healing, and none of them had infection, inflammatory secretion and nervous symptom. There were no differences in blood routine test, serum calcium, serum phosphorus between patients in two groups. One case filled by PMMA and two cases filled by CHC presented leakage, and none had nervous symptom.CONCLUSION: As the filling materials for vertebropalsty, CHC can restore the vertebral heights and relieve pain safely and effectively, however, its efficacy to relieve pain is not significant as PMMA in the short term.

Objective:To study the effect of Xiaoyao Powder on Alzheimer's disease in hippocampal CA 3βregion of rats PP-2A,GSK-3βexpression.Methods:Rats were randomly divided into four groups , including model group, western medicine group,Chi-nese medicine group were treated with intraperitoneal injection of D-gal and A-β1-42 peptide bilateral hippocampal injection mold-ing, physiological group only with equal volume of sterile saline intraperitoneal and hippocampal injection molding .The model was completed, normal group, model group were perfused with saline , western medicine group and Chinese medicine group were treated with oxiracetam solution and Xiaoyao decoction , four groups of intragastric volume was 0.5 ml/100 g, 1 time a day, continuous 28 d. After intragastric administration of isolated rat brain immediately , packet marking in 4℃4%glutaraldehyde solution of glass container , stored at 4℃.Repair piece, cut from the hippocampus, embedded in paraffin, sliced.Dilution of PP-2A for 1∶200, GSK-3βdilution of 1∶150.Images were analyzed by using Image-pro Plus 5 image analysis system, data were conducted by SPSS11.5 statistical analysis software, the comparison between 4 groups by single factor analysis of variance , between the two two groups was compared by LSD-t test, the test level of α=0.05.Results:The expression of PP-2A positive cell number and the positive area , average optical density, integral optical density index , in Xiaoyao Powder orally intervention compared with the model group increased significantly (P<0.01);GSK-3βabove indices were significantly decreased than that in model group after Xiaoyao Powder after intragastric ad -ministration (P<0.01).Conclusion:Xiaoyao Powder can up regulate the expression of PP-2A and down regulate expression of GSK-3β, may be condensed A-β1-42 peptide induced hyperphosphorylation of Tau has certain inhibition .

Objective:To investigate the correlation between anthropometric indices and arteriosclerosis detection indicators in the middle-aged and the elderly .Methods: A cross-sectional descriptive study was made of 1 626 individuals ( diabetics patients 23.37%, hypertensive subjects 39.48% and healthy individuals 37.15%), aged 45 to 90 years [mean age:(61.60 ±10.22) years)] in Shijingshan Dis-trict, Beijing.Their measurements:body mass index (BMI), waist circumference (WC), and waist to height ratio ( WHtR ) .Arterial stiffness was assessed according to brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), augmentation index (AI) and ankle-brachial index (ABI), which were measured by noninvasive detectors and equipment .The correlations between the various indi-cators were analyzed .Results:The percentages of the hypertensive and diabetic groups of central obesity ( male WC>85 cm, female WC >80 cm or WHtR>0.5 ) and of general obesity ( BMI>28 kg/m2 ) were significantly higher than those of the healthy group ( P<0 .01 ) .The difference between the two disease groups was not significant ( P>0 .05 ) .There was a moderate positive correlation between the measures of abdominal obesity (WHtR and WC) and the general obesity indicators (BMI) (r=0.710 and 0.716) .In the healthy group , WC and WHtR showed positive correlation with baPWV , IMT and ABI, and negative correlation with AI 75 .BMI showed positive correlation with IMT and negative correla-tion with AI75 , and no correlation with baPWV and ABI .There was negative correlation between BMI and baPWV in the diabetic group .In the hypertension group , we found negative correlation between BMI and baPWV, maximum IMT, AI75 , and also between WC and AI 75 .The simple regression straight line of baPWV versus the anthropometric parameters showed that the regression equations were y =0 .949 +1.379 x (baPWV vs.WHtR, R2 =0.046, P<0.001) and y=1.133+0.006x (baPWV vs.WC, R2 =0.027, P<0.001), respectively.baPWV and BMI did not have a linear relationship (P =0.62). Conclusion:WHtR and WC are superior to BMI indices in predicting arteriosclerosis .Anthropometric measurements for central obesity are good predictors of cardiovascular risk .