[Objective]To study the method of multi-spiral CT(MSCT) 3D reconstruction technique assisting cervical pedicle screw fixation(PSF) and double-door laminoplasty in the treatment of multilevel degenerative stenosis with traumatic instability(MDSTI) of lower cervical spine.[Method]From September 2006 to August 2007,PSF combined with double-door laminoplasty were performed in 9 patients with MDSTI of lower cervical spine.MSCT 3D reconstruction techniques,including volume rendering(VR) and multi-planar reconstruction(MPR),were used to assist preoperative diagnosis,plan and measurement to guide procedure.Postoperative MPR was used again:through coronal format,the degree of screws perforation was measured precisely and the different positions of pedicle screws were divided into three grades according to Richter's method;through axial format,the increase in sagittal diameter and canal area of every laminoplasty level were measured precisely.A comparison between pre- and postoperative ASIA scores was used to present neural function recovery.[Result]Nine patients with MDSTI of lower cervical spine underwent PSF and total 44 screws.According to the classification of Richter,grade 1 were 72.7%(32/44),grade 2 were 27.3%(12/44).No screw perforation occurred(grade 3) and no screws revision resulted from misplacement.No iatrogenic damage occurred.Double-door laminoplasty was performed in total 42 volumes.The postoperative cervical spinal canal sagittal diameter and traverse area were significantly improved(P

Objective To evaluate the level of granzyme B mRNA and perforin mRNA in urine on the diagnosis of renal acute rejection. Methods A total of 34 cases of renal transplantation were studied.The urine samples were measured with the use of a competitive and quantitative polymerase-chain-reaction assay for granzyme B mRNA and perforin mRNA and the data were analysed by using the SPLM statistical software,mRNA levels were log-transformed. Results The levels of granzyme B mRNA and perforin mRNA in urine were higher in patients with acute rejection than in patients without acute rejection.The level of perforin mRNA in patients with acute rejection was (1.2?0.4)fg/?g of total RNA and in patients without acute rejection was (-0.6?0.3)fg/?g of total RNA (P

0.05].The mean follow-up of 45 pat ients is 36(1～76) months.No local tumor recurrence has been noted. C onclusionsNSS can be performed with satisfactory result in RAML,and it is the first choice of surgical treatment.

Objective To explore CT features and clues to diagnosis of rhabdmyosarcoma(RMS) in head and neck .Methods 14 cases of rhabdmyosarcoma scanned by CT were co llected retrospectively during 1992～2001 and comparatively studied by the age o f patients and the pathologic types. Results Children and adolecence were mainly involved in R MS in head and neck which pathologic types were embryonal type and adeno-vesicle type ,and the former was the main type .CT features of rhabdomyosarcoma include d round and oval masses which had a homogeneous high density and close relation to muscles ,obvious enhancement after injection of contrast media ,often complic ated with the wide destruction of bone and other adjacent tissues,the collecting lymph node enlargment.Conclusion CT findings of rhabdomyosarcoma in head and ne ck had some features and combined with the age of patients can be made the diagn osis of RMS.

Objective To explore the application effect on theInternet plusused in basis surgical operation and formative evaluation. Methods The students of Chongqing Medical University who planned to study the basis of surgical operation in the 2015 academic year were randomly divided into two groups, with 166 students in the experimental group and 165 students in the control group.Internet plusmodel was used in the experimental group in surgery based teaching and the formative evaluation system; the control group used the traditional teaching mode and traditional formative assessment method. Indicators of forma-tive evaluation system include animal operation score, small group global impression, the homework score (small group overall form), the final exam results and operation examination results. After class, the ques-tionnaire was used to investigate the effect of students' learning. The t test or rank sum test of two groups of students were performed by using SPSS 17.0. Results Average scores of animals operation and homework score of the students in the experimental group were respectively (9.23 ±0.65) and (9.53 ±0.66), higher than in the control group (8.56 ±0.62) and (8.96 ±0.52), and the difference between the two groups had statistical significance (P<0.05). The results of the questionnaire showed that according to the students' self evaluation the students in the experimental group were superior to the control group (P=0.03) in the aspect of professional knowledge learning. Conclusion Internet plus used in surgery teaching and formative evaluation, can significantly improve the effect of teaching and promote students' learning.

Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

Objective To investigate the significance of serum procalcitonin(PCT)levels in children with respiratory syncytial virus(RSV)pneumonia and sepsis.Methods 43 cases of children with RSV pneumonia were divided into two groups,including 28 cases of non -sepsis and 15 cases of sepsis.30 cases of healthy children were choosed as a control group in the same period.The serum PCT levels of three groups were compared.The 29 cases of RSV pneumonia with other organ damage except lung were divided into non -severe group and severe group.The differences of serum PCT levels between the two groups were compared.Results The non -sepsis group and sepsis group serum PCT levels were (0.882 ±0.184)μg/L and (1.001 ±0.268)μg/L respectively,which were higher than the control group[(0.365 ±0.085)μg/L,(t =2.607,2.854,all P <0.05)].The serum PCT levels of the non -sepsis group and septic group were significant different(t =0.372,P >0.05);The serum PCT level of the severe group was (1.181 ±0.281)μg/L,which was higher than the non -severe group[(0.448 ±0.140)μg/L],the differ-ence was statistically significant(t =2.473,P <0.05).Conclusion The serum PCT of RSV pneumonia children was increased,the increased PCT can be an observed indicators of severe infection and multiple organ dysfunction.

Objective:To investigate the mechanism and effects of autophagy on cisplatin(DDP)-induced apoptosis in human gas-tric cancer cell line SGC7901. Methods:Cell proliferation was determined by an MTT assay after the SGC7901 cells were treated with DDP and/or chloroquine. Cell apoptosis was determined by flow cytometry. Autophagy and related protein expressions were detected by Western blot. Autophagy was quantitatively analyzed by fluorescence microscopy after monodansylcadaverine staining was per-formed. Results:The cells were treated with 5 mg/L of DDP for 24 h, the rate of cell apoptosis was (21.07 ± 2.12)%. Autophagy, char-acterized by an increase in the number of autophagic vesicles and LC3-II protein level, was observed in DDP-treated cells. After autoph-agy was inhibited by chloroquine, the rate of cell apoptosis was increased to (30.16 ± 3.54)%. In addition, caspase-3 and P53 protein levels were increased, but Bcl-2 protein was decreased. Conclusion:Autophagy protected human gastric cancer cell line SGC7901 from DDP-induced apoptosis. In addition, the inhibition of autophagy could promote apoptosis. The combined therapy of DDP and chlo-roquine may be a promising therapeutic strategy for gastric cancer.

Objective To observe the recent clinical efficacy of the sequential therapy hormone in the treatment of active rheumatoid arthritis.Methods In accordance with the principle of digital sheet,160 patients with active rheumatoid arthritis were randomly divided into the observation group and the control group,80 cases in each group.On the basis of methotrexate and leflunomide in both groups,the hormone sequential therapy was given in the observation group,but prednisone was given in the control group.The clinical efficacy of treatment after 1 week and 3 months were compared in two groups.Results In the observation group,the indicators in 7 d after treatment were significantly reduced,compared with untreated(t =19.90,7.63,14.73,7.58,6.84,14.09,all P ＜0.01),In the control group,three indicators of the duration of morning stiffness,joint tenderness index and joint swelling index in 7d after treatment were significantly reduced,compared with untreated (t =13.42,3.34,7.24,all P ＜ 0.01),Compared the indicators in the two groups in 7 d after treatment,there were statistically significant differences (t =13.07,4.92,10.51,5.23,5.74,15.03,all P ＜ 0.01).The indicators in the 3 months after treatment in both groups were signifi cantly decreased,buttherewasnosignificantdifferencebetweenthetwogroups (t =1.80,1.73,1.59,1.22,1.21,1.35,all P ＞ 0.05).The total effective rate was 80% in the observation group; but the rate was 75 % in the control group;there was no statistically significant difference in the two groups(x2 =0.57,P ＞ 0.05).Conclusion The sequential hormone therapy is an effective means for the treatment of active rheumatoid arthritis,by controlled the symptoms of rheumatoid arthritis effectively and alleviated the patient's condition.

Objective To investigate the effects of Dangshen (DS) extract saponins alleviating apoptosis in ischemia-reperfusion injury (I/R) of renal grafts and the mechanism. Methods The I/R injury model in SD rats was established after kidney transplantation. The SD rats were randomly divided into the following 3 groups (n = 20): sham operation group, I/R model group, DS saponin intervention group. Blood urea nitrogen (Bun) and creatinine (Scr) levels were determined at the 24th h after operation; apoptosis index (AI) was detected by using TUNEL method; the expression of Bcl2 and bax mRNA was detected by RT-PCR. Results As compared with the sham operation group,the blood Bun and Scr levels were significantly increased in the I/R model and DS saponin intervention groups (P＜0. 05). As compared with the DS saponin intervention group, the blood Bun and Scr levels were significantly increased in the I/R group (P＜0.05). The AI was significantly increased in the I/R model group and DS saponin intervention group. After DS saponin intervention, the AI was decreased from 40. 28 % in the I/R model group to 28. 45 % in the DS saponin intervention group (P＜0. 05). The expression of Bcl-2 mRNA in DS saponin intervention group and I/R model group was significantly decreased as compared with the sham operation group (P＜0. 05), but that of Bax mRNA was significantly increased in the I/R model group and DS saponin intervention group as compared with the sham operation group (P＜0. 05). After DS saponin intervention, the expression of Bcl-2mRNA was increased from 0. 25 in the I/R model group to 0. 391 (P＜0. 05), and that of Bax mRNA was decreased from 0. 565 in the I/R model group to 0. 473 (P＜0. 05). Conclusion DS extract saponin could significantly alleviate apoptosis in the I/R injury of renal grafts possibly by up-regulating the expression of Bcl-2 mRNA and down-regulating the expression of Bax gene.