BACKGROUND:The correct method selected according to the specific type and characteristics of lumbar disc herniation can achieve satisfactory effect, but in clinic, there stil some patients have recurrence symptoms after treatment. OBJECTIVE:To investigate the recurrence factors of spinal implant internal fixation for the treatment of lumbar disc herniation, as wel as the intervention measures. METHODS:Fifty-two patients with recurrence symptoms of lumbar disc herniation after internal fixation from January 2002 to December 2007 in the Department of Orthopedics, the 306th Hospital of PLA were retrospectively analyzed, including 28 male cases and 24 female cases, the average age was 43.2 years, ranged from 25-52 years. The time form first internal fixation to the recurrence was 3-192 months, average 38 months. The patients had the symptoms of lumbar and bilateral/unilateral leg pain and numbness. Al the patients underwent the anteroposterior radiographs of lumbar spine and the hyperextension and flexion lateral X-ray films to evaluate the stability of the lumbar spine. Lumbar magnetic resonance imaging was used to observe the intervertebral disc situation of the segment treated with lumbar internal fixation as wel as the spinal stenosis and disc degeneration. RESUTLS AND CONCLUSION:Among the 52 patients, 22 cases had recurrence lumbar disc herniation on the same segment after first internal fixation;four cases had recurrence symptoms caused by the spondylodiscitis after implant internal fixation;five cases had scar adhesions caused nerve compression on the site treated with internal fixation;10 cases had the symptoms of lateral recess and nerve root canal stenosis on the site treated with internal fixation;11 cases had recurrence symptoms caused by lumbar instability after internal fixation. It has reality clinical significance to analyze the reasons of recurrence of lumbar disc herniation after internal fixation

Objective To analyze the monitoring results of human and animal plague in Zhangye city from 1982 to 2011,and further explore the prevention and control policies and measures to control the spread of the disease.Methods The trends of human and animal plague were studied by retrospective survey in Zhangye city.Information of animal and human plague epidemic and prevention and control measures were collcoted and assessed with epidemiology methods,and the density of rodents,the rodents infected with flea,flea index and other indicators were calculated.Results 1982-2011,there were 6 cases of human plague incidence of 6 cases,of which 2 cases cured,4 cases died,the mortality rate was 67％; detection of Yersinia pestis from the captured 5167 animals was 93 strains from 1982 to 2011,the detection rate was 1.80％; 29 840 various vector insects were collected from the body surface of the 5167 animals captured,21 206 hole dries,and three marmot dens.A total of 7050 groups of Marmota parasites and hole stem fleas were inspected,52 strains of Yersinia pestis were isolated,and the average detection rate was 0.74％; 3912 marmot serums were detected,178 were positive,and the positive rate was 4.55％.Conclusions The prevention and control of plague is still very grim in Zhangye city.It is recommended to take publicity,education and active surveillance measures in the future to deal with emergencies and other.

Objective To assess the value of tumor marker immunostaining-FISH (TM-iFISH) technology on concen?trating and enumeration of tumor cells in CSF of lung cancer patients with leptomeningeal metastasis(LM). Methods Six cases of non-small cell lung cancer with leptomeningeal metastasis, which were diagnosed by CSF cytology or enhanced MRI scan, were selected. A total of 20 mL of CSF was collected in each case. TM-iFISH technology was employed to concen?trate and quantify circulating tumor cells in 7.5 mL CSF samples in each case while CSF cytology used 10 mL CSF samples in each case;Finally, the rest 2.5 mL CSF in each case was used for biochemistry assay. Results Ten CSF samples from 6 patients with non-small lung cancer with LM were assayed and tumor cells numbers ranging between 3 and 1 823 every 7.5 mL were found in 7 samples. On the other hand, CSF cytology examination only revealed tumor cells in 3 cases. Using CSF biochemical assay, higher than normal of protein level was found in 9 cases. TM-iFISH technology was employed again in 3 cases of patients who received treatment. Tumor cell count in CSF reduced in 2 out of the 3 cases. Conclusion TM-iFISH technology is a new method for detection and enumeration of tumor cells in the CSF in non-small cell lung cancer patients with leptomeningeal metastasis. This technology present diagnosis and curative values in lung cancer patients with leptomen?ingeal metastasis.

ObjectiveTo explore the expression of MRP1 and CD34 in colorectal carcinoma tissue and the relationship with clinicopathological factors.MethodsImmunohistochemical streptavidin-perosidase method was used to examine the expression of MRP1 and CD34 in 53 cases with colorectal carcinoma and normal colorectal tissue.The correlation between the levels of MRP1and CD34 expression and clinicopathological factors were analyzed.ResultsThe positive expression rates of MRP1 in the carcinoma group and normal colorectal tissue group were 49.1％ and 15.1％ respectively,and there was a significant difference of the positive expression between the two groups( x2 =14.029,P ＜ 0.01 ).The expression of MRP1 had no correlation with the degree of differentiation,the depth of invasion,the metastasis of lymph node and all the other clinicopathological factors ( P ＞ 0.05 ).CD34 value in the carcinoma group and normal colorectal tissue group were ( 35.63 ± 12.23 ) MVD/HP and ( 6.12 ± 0.97) MVD/HP,respectively,and there was a significant difference between the two groups (t =17.565,P ＜ 0.01 ).CD34 was not correlated with age,sex,tumor size,localization of the primary tumor ( P ＞ 0.05 ),but correlated with Dukes staging,lymph node metastasis,differentiation of the tumor,depth of invasion( all P ＜ 0.05).ConclusionThe overexpression of MRP1 and CD34 protein may involve in colorectal carcinogenesis;MRP1 may involve in the primary multidrug resistance in colorectal carcinoma.; CD34 may involve in the colorectal carcinoma invasion and metastasis.Investigating the expression of MRP1 and CD34 in colorectal carcinoma simultaneously can provide new referential indexes for the treatment and prognosis of colorectal carcinoma.

Objective:To investigate the effectiveness of immunoFISH technology in detecting tumor cells in cerebrospinal fluid (CSF) for adjuvant diagnosis of meningeal metastasis from lung cancer. Methods:Circulating tumor cells (CTCs) were detected by im-munoFISH technology in CSF samples from 16 patients with meningeal metastasis from lung cancer and 8 patients with non-tumorous brain diseases. Meningeal metastasis from lung cancer was diagnosed on the basis of neurological symptoms and confirmed by en-hanced magnetic resonance imaging and CSF cytological examination. Results:The number of CTCs was significantly greater in pa-tients with meningeal metastasis from lung cancer than in those with non-tumorous brain diseases (P<0.01). The critical point of the maximum correct diagnosis index (Youden index) was regarded as the judging criterion for the positive tumor cells in CSF based on the receiver operating characteristic curve. When one tumor cell existed in 7.5 mL of CSF, the area under the curve was 0.875, and the 95%confidence interval ranged from 0.705 to 1.000. The diagnostic sensitivity, specificity, effectiveness, positive predictive values, and neg-ative predictive values were 75.0%, 100.0%, 83.3%, 100.0%, and 66.7%, respectively. Conclusion:ImmunoFISH technology provides great significance in detecting CTCs in CSF to diagnose meningeal metastasis from lung cancer.

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Objective To study the diagnosis and operative treatment of redundant sigmoid colon in children.Methods The length of sigmoid flexure was measured by enema examination in children with constipation,if it was over the normal scope,redundant sigmoid colon were come into existence.Twenty-three cases were treated by operated,hemicolectomy were done in 14 of 23 cases,others were treated by Soave′s procedure through transanal local excision.Results Symptoms disappeared completely in 18 of 23 cases and decreased in 5 cases.Nine cases were cured after Soave's procedure through transanal local excision.There were significant differences between 2 groups(P

BACKGROUNDComputer-aided diagnosis (CAD) of lung cancer is the subject of many current researches. Statistical methods and artificial neural networks have been applied to more quantitatively characterize solitary pulmonary nodules (SPNs). In this study, we developed a CAD scheme based on an artificial neural network to distinguish malignant from benign SPNs on thin-section computed tomography (CT) images, and investigated how the CAD scheme can help radiologists with different levels of experience make diagnostic decisions.

METHODSTwo hundred thin-section CT images of SPNs with proven diagnoses (135 small peripheral lung cancers and 65 benign nodules) were analyzed. Three clinical features and nine CT signs of each case were studied by radiologists, and the indices of qualitative diagnosis were quantified. One hundred and forty nodules were selected randomly to form training samples, on which the neural network model was built. The remaining 60 nodules, forming test samples, were presented to 9 radiologists with 3 - 20 years of clinical experience, accompanied by standard reference images. The radiologists were asked to determine whether a nodule was malignant or benign first without and then with CAD output. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis.

RESULTSCAD outputs on test samples had higher agreement with pathological diagnoses (Kappa = 0.841, P < 0.001). Compared with diagnostic results without CAD output, the average area under the ROC curve with CAD output was 0.96 (P < 0.001) for junior radiologists, 0.94 (P = 0.014) for secondary radiologists and 0.96 (P = 0.221) for senior radiologists, respectively. The differences in diagnostic performance with CAD output among the three levels of radiologists were not statistically significant (P = 0.584, 0.920 and 0.707, respectively).

CONCLUSIONSThis CAD scheme based on an artificial neural network could improve diagnostic performance and assist radiologists in distinguishing malignant from benign SPNs on thin-section CT images.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Lung ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Neural Networks (Computer) ; ROC Curve ; Radiographic Image Interpretation, Computer-Assisted ; Solitary Pulmonary Nodule ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate the effects and mechanisms of diethylhexylphthalate (DEHP) on morphology and function of progenitor Leydig cells (PLC) in rats.

METHODSTwenty pregnant SD rats were randomly divided into 4 groups ( n = 5): normal control group, DEHP low dose group , middle dose group, and high dose group, which were treated from postnatal day (PND) 1 to PND 21 of the pubs with DEHP at the doses of 0, 10, 100, 750 mg/(kg · d) in 0.5 ml of corn oil by gavage respectively. At the end of the treatment, the male pups were killed and blood samples were collected for determination of serum testosterone concentration by chemiluminescence method. The body weight, testis weight and anogenital distance (AGD) were measured. The morphology of PLC was observed by light and transmission electron microscopy. The protein expression of steroidogenic acute regulatory protein(StAR) in PLC was determined by immunohistochemistry. The mRNA expression of insulin-like growth factor-I (IGF-I) in the testis was assayed by real-time PCR.

RESULTSCompared with normal control group, the serum testosterone and AGD of male pubs from the middle and high dose groups were declined significantly (P < 0.01), the testis weight and body weight from high dose group were decreased significantly (P < 0.01), while the testis weight increased in the low dose group (P < 0.05). Under light microscope, PLC showed hyperplasia and cluster aggregation in the low dose group and focal hyperplasia in the middle and high dose group. The spermatogenic cells in seminiferous tubules showed decrease, apoptosis and unfix in the high dose group. Under transmission electron microscope, the PLC showed decreased lipid droplets, smooth endoplasmic reticulum and mitochondriae in the treated group. The mRNA expression of IGF-I increased in the low dose group, and the protein expression of StAR decreased in the middle and high dose group.

CONCLUSIONLactating exposure to DEHP may interfere with the synthesis of testosterone of PLC in male pubs, the decrease of StAR and the damage of PLC may be involved in it.

Animals ; Body Weight ; Diethylhexyl Phthalate ; adverse effects ; Female ; Germ Cells ; drug effects ; Insulin-Like Growth Factor I ; metabolism ; Lactation ; Leydig Cells ; cytology ; drug effects ; Male ; Organ Size ; Phosphoproteins ; metabolism ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; cytology ; drug effects ; Testis ; Testosterone ; blood

Objective To analyze the disease-free survival (DFS) and prognostic factors for stage Ⅰ_b cervical squamous cell carcinoma treated by radical hysterectomy. Methods From January 1999 to December 2005, a total of 206 patients with uterus cervical squamous cell carcinoma were retrospectively analyzed. All the patients were treated by type 3 hysterectomy and pelvic and/or para-aortic lymphadenectomy at Cancer Hospital, Chinese Academy of Medical Sciences. The diseases were stage Ⅰ_(B1) and Ⅰ_(B2)= in 103 patients each. Seventy-nine (76.7%) patients had preoperative radiotherapy and 111 (53. 9%) had postoperative adjuvant treatment (PosAT). Prognostic factors were analyzed using univariate model and multivariate Cox model. Results The follow-up rate was 92. 7%. 106 patients had following-up time of five years. The overall 5-year survival rate and the disease-free survival rate of stage Ⅰ_b,Ⅰ_(B1) and Ⅰ_(B2) were 96. 3% and 86. 8%, 100% and 94. 6%, 92. 2% and 77.9%, respectively. Univariate predictors of DFS included tumor size (FIGO stage, 77.9% : 94. 6% ; Χ~2 = 5. 58, P = 0. 018), lympho-vascular space involvement (LVSI, 74.6% : 89. 8% ; Χ~2 = 10. 44, P =0. 001), vaginal involvement (purely fornix involvement was not included disease, 50% : 87. 9% ; Χ~2 = 7.01,P = 0. 008), parametrial involvement (PI, Χ~2 = 17.69 ,P = 0. 000), and metastatic lymph nodes (LNM) > 2 (Χ~2 = 21.47, P = 0. 000) in stage Ⅰ_b disease, while LVSI (Χ~2 =6. 35,P =0. 012), PI (Χ~2 =90.00,P =0. 000) and LNM >2(Χ~2 =26. 27,P = 0. 000) in stage Ⅰ_(B1) disease, LVSI (Χ~2=10. 12,P =0. 001), cervical canal involvement (Χ~2 =4. 60,P = 0.032), vaginal involvement (Χ~2 =5.87,P=0.015), PI (Χ~2 =4.78,P=0.029) and LNM >2(Χ~2= 6. 72, P = 0. 010) in stage Ⅰ_(B2) disease. In multivariate analysis, FIGO stage (Χ~2 = 4. 73 ,P =0. 030), LVSI (Χ~2 = 9. 81, P = 0. 002), and LNM > 2 (Χ~2 = 6. 30, P = 0. 012) were significantly associated with DFS in stage Ⅰ_b, while LVSI (Χ~2 = 6. 38, P = O. 012) and LNM > 2 (Χ~2 = 3.92, P = 0. 048) were significantly associated with DFS in stage Ⅰ_(B2)-Conclusions LVSI is an important prognostic factor for stage Ⅰ_(B1) cervical cancer. PosAT reduces the recurrences in stage Ⅰ_(B2) desease. When PosAT is needed, preoperative radiotherapy can not improve DFS. PosAT should not be commonly used for stage Ⅰ_(B1) disease with only deep muscularis invasion.