BACKGROUND:As for patients with one-side backleg pain who were candidates for surgery treatment of lumbar intervertebral disc herniation, the common treatment includes lumbar vertebral plate opening and decompression, and laminectomy in combination with compression and bilateral pedicle screw fixation. However, these therapeutic approaches are not satisfactory. OBJECTIVE:To explore the feasibility and efficiency of single-side lumbar interbody fusion and unilateral pedicle screw fixation for treatment of lumbar intervertebral disc herniation patients with one-side backleg pain. METHODS:Forty patients with single-side lumbar disc herniation, suffering from unilateral backleg pain, were recruited from Shihezi People’s Hospital, China and were treated with single-side lumbar interbody fusion and unilateral pedicle screw internal fixation. The neurological function of patients was assayed using Japanese Orthopaedic Association score system before and after treatment, the improvement rate and excellent/good rate were calculated. Suk criterion was used to determine fusion status. RESULTS AND CONCLUSION:The mean fol ow-up period for 40 patients was ranging from 6 months to 60 months. Al incisions healed wel , with no infection. The Japanese Orthopaedic Association score after 6 months of treatment was significantly higher than that before treatment (P<0.05), with the excellent and good rate up to 88%. According to Suk criterion, 38 patients achieved bone graft fusion or possible fusion, with interbody fusion rate 95%, as revealed by radiographic and CT evidence. The remaining two patients were detected fusion at 9 months after treatment. Our findings indicate that, single-cage lumbar interbody fusion combined with single-side pedicle screw fixation is the feasible surgical technique and provides satisfactory effects in treating single-side lumbar disc herniation.

BACKGROUND:Human umbilical cord blood-derived mesenchymal stem cels can be induced through the co-culture to differentiate into other cels, but how to get more seed cels for tissue engineering is one of the most difficult problems. OBJECTIVE: To investigate the role of the different concentrations of thyroxine in chondrogenic differentiation of human umbilical cord blood-derived mesenchymal stem cels by co-culture with rabbit chondrocytes. METHODS:Human umbilical cord blood-derived mesenchymal stem cels were co-cultured with rabbit chondrocytes at 2:1, and stimulated by medium containing different concentrations of thyroxine (0, 0.01, 0.1 and 1, 10 μmol/L). Co-cultured cels with no thyroxine served as control group. After 14 days of co-culture, the cel RNA and protein were extracted, mRNA expressions of aggrecan and colagen type II were detected by real-time PCR, and protein expression of aggrecan and colagen type II were detected by western blot assay. RESULTS AND CONCLUSION:After intervention with 0.01, 0.1, 1, 10 μmol/L thyroxine, the mRNA and protein expressions of aggrecan and colagen type II were enhanced with the increase of thyroxine concentration, which were significantly different from those in the control group (P < 0.05). Experimental findings indicate that high levels of thyroxine can enhance the chondrogenic ability of human umbilical cord blood-derived mesenchymal stem cels co-cultured with rabbit chondrocytes.

Objective: To investigate the hyponatremia incidence in patients with ruptured intracranial aneurysms and the correlation with Fisher grading and cerebral vasospasm. Methods: Totally 150 patients with ruptured intracranial aneurysms from March 1998 to May 2001 were divided into anterior communicating artery (ACoA) group,posterior communicating artery (PCoA) group and middle carotid artery(MCA) group according to the sites of aneurysms.The patients were treated with GDCs interventionally and the incidences of hyponatremia were analyzed. Results: The incidences of hyponatremia in 3 groups were 48%(32/67),15%(8/52) and 16%(5/31),respectively; The incidences of severe hyponatremia of 3 groups were 30%(20/67),6%(3/52) and 6%(2/31), respectively. In ACoA group, the incidences of hyponatremia in Fisher grade Ⅲ-Ⅳ and Ⅰ-Ⅱ were 67%(20/30) and 32%(12/37) and the incidences with and without vasospasm were 71%(24/34) and 24%(8/33), respectively. Conclusion: The ACoA group has a significantly higher incidence of common and severe hyponatremia than the other groups. In ACoA group,hyponatremia is significantly more often in Fisher grade Ⅲ-Ⅳ cases and those with vasospasm.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective To study the relationship between metabolic syndromes and uric acid calculi.Methods We retrospectively analyzed medical records of 640 adult patients,who were diagnosed as renal calculi and finished the stone composition analysis.Among them,394 cases were male and 246 were female.The averagc age was (50.9 ± 12.8) years old.According to the diagnostic criteria of the MS,the patients were divided as metabolic syndrome group (metabolic syndrome group /MS group and non-metabolic syndrome group (non MS group);the MS group had a total of 238 cases including 151 males and 87 females.The average age was (54.1 ± 11.0) years old.There were 402 cases in non MS group,including 243 males and 159 females,with an average age of (49.1 ± 13.4) years old.We obtained corresponding metabolic indices.By comparing the differences between each group,the statistic were analyzed with SPSS.Results In the MS group,42 cases was diagnosed with uric acid stones,and the nonMS group with 8 cases diagnose with uric acid stones.The MS included obesity,elevated blood pressure,elevated fasting plasma glucose,high serum triglycerides.In the patients obtained,123 had the 4 kinds of metabolic diseases at a time,and 23 (18.7％) cases were diagnosed as uric acid stones.115 patients had the 3 kinds of metabolic diseases in which 19 (16.5％) cases were uric acid stones.190 patients had 2 kinds of metabolic diseases and 5(2.6％) cases were uric acid stones.137 patients had only one kinds of metabolic disease in which 3 were uric acid stones.The multivariate Logistic regression analysis showed that,after the correction of gender and age,obesity patients own the OR as 1.10(0.98-1.24)(P =0.018),high blood sugar had the OR as 1.72(1.19-1.92) (P =0.006),high glycerin three fat had the OR as 0.71(0.48-1.09) (P =0.032) and high HDL-C was 0.15(0.03-0.65) (P =0.01).Conclusions The metabolic syndromes including obesity,hyperglycemia and dyslipidemia obviously might influenced the formation of uric acid calculi.

Objective To investigate the perioperative hemodynamic features of mitral replacement of patients with small left ventricle.Methods Patients with left ventricle end-diastolic dimension (LVEDD) less than 40mm received mitral replacement sur- gery were divided into big size M-2 group and small size M-1 group.The perioperative echo results were analyzed with SPSS software. Results The big size M-2 group has lower trans mitral gradient [ (5.9?1.6) mm Hg vs.(10.7?3.2) mm Hg],larger in vivo va- lular acre[ (2.9?0.2) cm~2 vs.(2.6?0.2) cm~2],and high mitral match index [(1.92?0.23) cm~2/m~2 vs.(1.73?0.18) cm~2/m~2 ].Conclusion With the meticulous perioperative treatment and myocardial protection,the patients with small left ventricle should also receive a mitral replacement as big as possible to achieve the ideal hemodynamics results.

OBJECTIVETo investigate the clinical features, surgical transcranial approaches and outcomes of giant pituitary adenomas.

METHODSA series of 112 consecutive cases of giant pituitary adenomas underwent microsurgery through transcranial approaches at People' s Liberation Army General Hospital were retrospectively analyzed. Of the 112 patients, 58 were male and 54 were female, with age ranging from 3 to 72 years(mean age 44. 3 years). There were 91 non-functioning adenomas and 21 hormone-secreting adenomas. The maximum tumor diameter varied from 4. 0 to 7. 2 cm, with mean diameter of 4. 8 cm. Unilateral subfrontal approach was chosen in 16 cases, pterional approach in 41 cases, anterior interhemispheric approach in 34 cases, transcallosal-interforniceal approach in 6 cases, transcortical- transventricular approach in 5 cases, combined approach in 6 cases and other approaches in 4 cases. Postoperative MRI and endocrine function were re-examined routinely to evaluate the therapeutic efficacy. Staged operation through transsphenoidal approach or adjuvant treatments including medical and radiation therapies were administered in patients with hormone-secreting adenomas when hormonal excess persisted after surgery and in patients with non-functioning adenomas who had postoperative MRI evidence of residual tumor.

RESULTSTotal removal of the lesion was achieved in 57 cases (50. 9%) , 26 patients (23. 2%) underwent subtotal resection, and 29 patients (25. 9%) underwent partial removal. Postoperative mortality occurred in 3 patients (2. 7%). Major surgical morbidity occurred in 38 patients (33. 9%). Vision was preserved or improved in 98 patients (87. 5%). The postsurgical follow-up period varied from 3 to 64 months (mean 19. 5 months) . Nineteen of the 21 patients with hormone-secreting adenomas were considered to be in hormonal remission, and 87. 2% of the cases were capable of normal work and life and 8 patients suffered recurrence during the followed-up period.

CONCLUSIONSSelection of appropriate transcranial approaches is the key to successful microsurgery for giant pituitary adenomas according to the morphological characteristics presented in image examinations and clinical symptoms. Staged transsphenoidal operation and/or adjuvant therapies including medical and radiation therapies offer the best chances to control the residual tumors after the maximal surgical removal of giant adenomas through transcranial approaches.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Postoperative Period ; Retrospective Studies ; Young Adult

ObjectiveTo explore sensitivities and specificities of Nutritional Risk Screening 2002 ( NRS 2002),Subjective Global Assessment (SGA),and Mini Nutritional Assessment (MNA) in the detection of blood prealbumin level.MethodsTotal 126 patients were consecutively enrolled from the oncology departments of three hospitals from November,2010 to March,2011.Nutritional screenings or assessments were performed on the next morning of hospital admission by nutritionists and medical oncologists using NRS 2002,SGA,and MNA.Prealbumin ( ＜ 180 g/L) was used as the reference standard of malnutrition (undernutrition) for assessing the sensitivities/specificities of these tools.ResultsAll 126 patients completed nutritional screening or assessment using the above three tools.The prevalence of malnutrition (undernutrition) determined by NRS 2002,SGA and MNA was 67.0％,46.2％,and 64.8％,respectively.With prealbumin in relation to clinical outcome as the reference standard,the sensitivities ofNRS 2002,SGA,and MNA were 78.2％,58.2％ and 89.1％,and the specificities were 50.0％,72.2％,and 27.8％,respectively.ConclusionsAmong these three tolls,NRS 2002 detects the nutrition risks,whereas SGA and MNA detect malnutrition.Since prealbumin is not an appropriate reference standard,it can not be used for the comparison among the three tools.Nevertheless,NRS 2002 reflects the clinical outcomes,and therefore is suitable for inpatients.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

Objective:To investigate and evaluate the anti-tumor activity of hydroxychloroquine ( HCQ) in vitro. Methods:CCK-8 assay was applied to detect the inhibitory effect of HCQ at different concentrations(4. 78, 9. 55, 19. 10, 38. 20,76. 40 μg?ml-1 ) on A549 cells, HepG2 cells, HT-29 cells, K562 cells, Hela cells and B16 cells. Absorbance was detected by a microplate reader, and then the inhibitory rate of the tumor cells and the IC50 was calculated. Results:Compared with those of the negative control group, the inhibitory rates of HCQ at different concentrations against the six tumor cells were all increased significantly in a dose-dependent manner (P<0. 01). The inhibitory rates of the tumor cells were all above 60% when the concentration reached 38. 20μg?ml-1. The IC50 was 26. 70(A549), 27. 47(HepG2), 5. 72(HT-29), 14. 03(K562), 20. 21(Hela) and 13. 62(B16) μg?ml-1, respectively. Conclusion:HCQ shows anti-tumor activity on several cancer cells in vitro. There may be a good application prospect for HCQ in the treatment of colorectal cancer, liver cancer, cervical cancer, melanoma and leukemia.