Objective To investigate the upper airway caliber and the corresponding pharyngeal wall in obstructive sleep apnea syndrome(OSAS) by spiral CT.Methods Seven patients with OSAS confirmed by polysomnography(PSG) underwent spiral CT scan.The thickness of posterior pharyngeal wall of retropalatal region(RP),retroglossal region(RG) and epiglottal region(EPG) were measured.Results ①Among 7 patients,5 had only RP obstruction,and 2 had RP and RG regions obstruction;②The length and width of soft palate were 44.28 mm?1.16 mm(normally 41.90 mm?1.95 mm) and 9.42 mm?0.46 mm(normally 5.84 mm?0.24 mm) respectively;③In OSAS patients,the thickness of posterior pharyngeal wall of RP,RG and EPG region were statistically larger than that of the normal group.Conclusion Spiral CT is of practical value in evaluating the pharyngeal airway obstruction of OSAS.

Hedgehog family proteins are important morphogens which mediate the development of embryo as well as the carcinogenesis in adults. Inappropriate activation of Hedgehog signaling pathway contributes to numerous human cancers. The Hedgehog signaling pathway is considered to be involved in the molecular mechanism of the invasion and metastasis of the tumors, and to facilitate the metastasis of tumors through signaling pathways interaction. It is suggested that a potential therapeutic strategy pharmacologically targeting Hedgehog-dependent tumors may be developed.

Objective To evaluate the feasibility and clinical effect of stage Ⅰ posterior vertebral corpectomy filled with titanium mesh cages plus long-segmental instrumentation for treatment of Denis type D and E severe unstable thoracolumbar burst fracture.Methods A retrospectively review was made on 14 patients with Denis type D and E severe unstable thoracolumbar burst fracture,having had posterior vertebral corpectomy,titanium mesh bone grafting and long-segmental pedicle screw fixation.Parameters recorded were operation time,amount of bleeding,bone fusion and reduction,postoperative complications,low back pain,neurological performance,restoration and loss of anterior vertebral height,correction and loss of kyphosis,and intraspinal space occupying lesion.Results Mean operation time was 207.1 min (range,148-306 min) and blood loss was 585 ml (range,300-1,500 ml).Intraoperative fracture reduction was satisfactory.Follow-up ranged from 18 to 54 months (mean,28 months),which showed no complications of infection,screw-rod breakage,loosening or shifting of the internal fixation device,titanium mesh subsidence and pseudarthrosis,and no signs of adjacent segment degeneration.Six months after operation,CT scan showed bony fusion of the bone-implant interface.At the final follow-up,the Denis pain scale improved significantly including 12 patients with completely relieve of pain (P1) and 2 ache slightly but no need of taking painkiller (P2).Neurological functions were improved by 1-3 degree in all patients.Percentage of anterior vertebral height was (41.2 ± 8.9)％ before operation,significantly reduced to (8.3 ± 4.8) ％ one week after operation and to (8.9 ± 5.1) ％ at the final follow-up (P ＜0.01).Mean loss of anterior vertebral height was 0.6％.Sagittal kyphotic angle was (36.9 ± 4.9) °before operation,significantly reduced to (8.1 ± 3.4) ° one week after operation and (8.5 ± 3.8) °at the final follow-up (P ＜0.01).Mean loss of kyphotic angle was 0.9°.Ratio of intraspinal space occupancy was (74.9 ± 11.3) ％ before operation but recovered to (4.1 ± 1.6) ％ one week after operation and (1.8 ± 1.4) ％ at the final follow-up,with significant differences in pair comparison (P ＜ 0.01).Conclusion The use of posterior vertebral corpectomy and fusion with titanium mesh cage fusion in conjunction with long-segment instrumentation are effective for spinal canal decompression,fracture reduction,three-column reconstruction as well as rigid fusion at one stage,lumbar pain relief,neurological function recovery,prevention of correction loss and vertebral height restoration.

For better adaptation to clinical work and scientific research as well as self-development,medical postgraduates are required to improve their reading ability to harvest information from medical English articles.Constructing formal schema based on linguistic schema and enriching content schema can significantly enhance medical English reading ability,according to schema theory and education practice.Therefore,the learning mode was explored based on schema theory and this theory was applied in practice to elevate reading ability by means of reading report.

Objective To study the clinical effects of the artificial vertebral body of the biomimetic nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite for the structural reconstruction and the height restoring of the vertebral body in the thoracolumbar fractures by the anterior surgical procedures. Methods From December 2003 to January 2006, 42 patients with thoracolumbar fractures received the anterior surgical procedures to decompress and reconstruct the spinal vertebral structure with the artificial vertebral body of the n-HA/PA66 composite. Among the patients, there were 28 males and 14 females, aged 17-67 years, averaged 43.6 years. The thoracolumbar fractures developed at T12 in 5 patients, at L1 in 17, at L2 in 14, and at L3 in 6. The height of the anterior border of the vertebral body amounted to 29%-47% of the vertebral body height, averaged 40.6%. The Cobb angle on the sagittal plane was 21-38° averaged 27.6°. According to the Frankel grading scale, the injuries to the nerves were as the following: Grade A in 7 patients, Grade B in 19, Grade C in 8, Grade D in 6, and Grade E in 2. Results All the 42 patients were followed up for 6-25 months. Among the patients, 36 were reconstructed almost based on the normal anatomic structure, and 6 were well reconstructed. The mean height of the anterior border of the vertebral body was 40.6% of the vertebral body height before operation but 91.7% after operation. And the reconstructed height of the vertebra was maintained. The mean Cobb angle on the sagittal plane was 27.6°before operation but 13.4° after operation. All the patients had a recovery of the neurological function that had a 1-grade or 2-grade improvement except 7 patients who were still in Grade A and 2 patients who were in Grade D. The implant was fused 3-5 months after operation. No infection, nail break, bar/plate break or loosening of the internal fixation occurred. Conclusion The artificial vertebral body of the biomimetic n-HA/PA66composite can effectively restore the height and the structure of the vertebra, can be fused with the vertebral body to reconstruct the spinal structural stability effectively, and can be extensively used in the clinical practice.

AIM:To observe the changes in plasma rennin activity(PRA)and angiotensin Ⅱ(AngⅡ)level and the cytoskeletons in dorsal hippocampus(DH)in male and female stressed rats.METHODS:The adult Sprague-Dawley male and femal rats were stressed for 6 h per day.Three days later,the levels of PRA and AngⅡin plasma were determined by radioimmunoassay,and the expression of nestin and NF200 in dentate gyrus(DG)and CA3 regions were observed with immunohistochemical staining.RESULTS:①The levels of PRA in plasma of male or female rats were decreased in stressed rats compared with control groups(P

ObjectiveTo investigate the effects of ligustrazine on renal tubulointerstitial injury in adriamycin nephrosis rats and its mechanism.MethodsForty male Sprague-Dawley rats were randomly divided into sham-operation group,model group,ligustrazine group and Benazepril group.The rat nephropathy model was established by adriamycin injection and unilateral nephrectomy.The 24-hour urinary protein excretion at the start,2nd,4th,6th weekends was analyzed.All rats were sacrificed at the 6th weekend,and then the renal function and the tubulointerstitial pathological injury were examined.Immunohistochemistry was used to measure the expression of ET-1.ResultsThe 24-hour urinary protein excretion [ (30.07 ±2.12) mg/24 h,(201.83 ± 8.63 ) mg/24 h,( 470.70 ± 58.79 ) mg/24 h ] ( at the 2th,4th,6th weekend),blood urea nitrogen[ BUN( 20.20 ± 2.65 ) mmol/L],serum creatinine[ Scr ( 86.79 ± 2.20 ) μmol/L),tubulointerstitial pathological injury (4.38 ± 0.26) and the expression of ET-1 ( 126.92 ± 3.63 )in model group were significantly higher than those in sham-operation group [ ( 6.75 ± 2.07 ) mg/24 h,( 8.28 ± 0.71 ) mg/24h,( 25.37 ± 4.30) mg/24 h,( 8.93 ± 1.05 ) mmol/L,(49.00 ± 5.34 ) μmol/L,1.06 ± 0.19,32.09 ± 3.71,P ＜ 0.01 ].Compared with model group,the 24-hour urinary protein excretion [ ( 176.93 ± 9.20)mg/24 h,( 270.45 ± 60.21 ) mg/24 h) ( at the 4th,6th weekend),BUN [ ( 13.75 ± 2.60 ) mmol/L ],Scr [ ( 62.49 ±3.29)μmol/ L ],Renal tubulointerstitial pathological injury (2.78 ± 0.10) and the expression of ET-1(57.44 ± 4.98 ) were significantly decreased in ligustrazine group( P ＜ 0.01 ).ConclusionsLigustrazine can downregulate the expression of ET-1 and decreased urinary protein excretion,leading to reduce tubulointerstitial inflammation and fibrosis.

The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P < 0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P < 0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.
Back ; Decompression, Surgical ; Durapatite ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; Nanostructures ; Nylons ; Spinal Fusion ; Treatment Outcome

Objective To observe the efficacy ,safety and patient acceptance of the artificial airway with the oro‐pharyngo‐laryn‐gead airway cap(OPLAC) for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia .Methods Sev‐enty eight cases of patients receiving the hip replacement surgery were included ,42 patients were to be adopted to establish artificial airway with the OPLAC for intravenous‐inhalation combined anesthesia ,another 36 patients treated with heath side‐lying position hypobaric spinal‐epidural anesthesia .There are two groups ,the oro‐pharyngo‐laryngead airway cap group(OPLAC ,n=42) and hy‐pobaric combined spinal‐epidural anesthesia group (CESA ,n=36) .Monitor the changes of respiratory and circulatory parameters of the two groups before the start of anesthesia ,anesthetic after 10 min ,30 min ,1 h ,and handling marrow ,observing occurrence of complications (delirium ,sore throat ,nausea ,vomiting ,deep vein thrombosis) ,following up the degree of satisfaction of patients and surgeons for anesthesia .Results The respiratory and circulatory parameters of the OPLAC group during anesthesia induction and maintenance were relatively stable ,on the other hand ,significant cyclic inhibition (blood pressure and heart rate decresing ) and re‐spiratory rate declining were observed in the CESA group after anesthesia ,cases with the use of atropine and dopamine significantly more than OPLAC group .The circulation and breath in the OPLAC group were relatively stable when handling marrow ,while cir‐culation fluctuating Significantly in the CESA group (blood pressure decreasing and heart rate increasing ) .The incidence of delirium in the CESA group was significantly higher than OPLAC group .The patient satisfaction of the OPLAC group was significantly bet‐ter than the CESA group .Conclusion The artificial airway with OPLAC for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia is safe ,effective ,and satisfactory .

Objective To investigate the relationship on the excision repair cross complementing gene 1(ERCC1)‐4533/8092 site single nucleotide polymorphisms(SNPs) and the susceptibility to hepatocellular carcinoma(HCC) in Guangxi Zhuang population . Methods Polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) method was used to detect the ER‐CC1‐4533/8092 gene polymorphism in 88 cases with primary liver cancer and 82 cases of normal controls .Results There was no difference in the frequency distribution of ERCC1‐4533 in the case group and the control group ,the frequency distribution of the ERCC1‐8092 in the case group and the control group was different(P< 0 .05) .Compared with ERCC1‐8092 CC ,ERCC1‐C8092 CA/AA had higher risk of primary hepatocellular carcinoma(CA :OR=2 .556 ,95% CI:1 .345 -4 .855;AA :OR= 8 .667 ,95% CI:1 .000-75 .092) .ERCC1‐8092 C allele as a reference ,ERCC1‐8092 A allele can increase the risk of primary liver cancer (OR=2 .387 ,95% CI:1 .428-3 .992) .Conclusion The genetic polymorphisms of ERCC1‐8092 sites are associated with susceptibility to hepatocellular carcinoma in Guangxi Zhuang population .