Objective To compare the feasibility and efficacy of intervertebral wedge osteotomy and pedicle subtraction osteotomy (PSO),vertebral column resection (VCR),Smith-Petersen osteotomy (SPO) for the treatment of severe kyphosis and scoliosis.Methods The data of 38 cases of severe kyphosis and kyphoscoliosis were retrospectively analyzed from January 2010 to February 2016,including 22 males and 16 females.According to the osteotomy mode,PSO,SPO,VCR and intervertebral disc wedge osteotomy were used to collect the average number of fixed phases,volume of bleeding,length of stay,length of hospital stay,improvement of main cobb angle,improvement of ODI score,and Frankel classification to evaluate the efficacy.Results There were no significant differences in the overall operative time between the four groups.The average number of fixation in 18 patients with SPO was (9.4±3.9) segments,the blood loss was (3 000±410) ml,the average Cobb angle was improved by 55.3％± 9.5％,the average postoperative hospitalization was (14.6±4.9) days,the improvement rate of ODI was 42.1％±7.4％,all the patients were improved to Frankel E;The average number of fixation in 5 patients with PSO was (7.6± 1.5) segments,the blood loss was (4 360± 1 161) ml,the average Cobb angle was improved by 58.9％ ± 15.1％,the average postoperative hospitalization was (18.2±7.0) days,the improvement rate of ODI was 41.3％±9.6％.One Frankel C patient was improved to Frankel D,others remained to be Frankel E as the same as pre-operation;The average number of fixation in 4 patients with VCR was (6.2±2.6) segments,the blood loss was (3 750+ 1 848) ml,the average Cobb angle was improved by 83.9％± 10.9％,the average postoperative hospitalization was (21±7.2) days,the improvement rate of ODI was 39.6％± 18.1％.Three Frankel D patients were improved to Frankel E and one Frankel C patient was improved to Frankel D;The average number of fixation in 11 patients with IWO was (7.1 ± 2.7) segments,the blood loss was (2855±1046) ml,the average Cobb angle was improved by 59.6％±22.05％,the average postoperative hospitalization was (13.5±2.7) days,the improvement rate of ODI was 51.3％±8.3％.One Frankel C patient was improved to Frankel D,eight Frankel D patients were improved to Frankel E,other patients remained to be Frankel E;The mean follow-up time was 25.2 months in 11 patients underwent intervertebral wedge osteotomy.All the patients had successful spinal fusion and no failure of internal fixation.Conclusion Intervertebral wedge osteotomy for the treatment of scoliosis and kyphosis could reduce surgical injury to obtain good biomechanics and surgical result.

Objective:Immunoregulation study of umbilical mesenchymal stem cell (UCMSCs) on allogeneic umbilical cord blood(UCB) CD4+T lymphocytes,which proliferation,apoptosis and the differentiation to CD4+CD25+ regulatory T cell (Treg) in vitro. Methods:Establishing on direct contact or transwell co-culture system,adopt in different proportion of UCMCs with phytohaemag-glutinin (PHA)-activated UCB CD4+T lymphocytes were co-cultured. The proliferation of lymphocyte,percent of CD4+CD25+/CD4+and Foxp3 expression, regulatory T cell marker gene were measured. Apoptosis of CD4+T lymphocytes were observed in the direct contact or transwell coculture system of UCMSCs with desamethason( DXM)-stimulated UCB CD4+T lymphocytes. Results: The UCB CD4+T lymphocytes cocultured with UCMSCs with PHA-activating for 3 days,compared with the UCMSCs free control group,the amount of cells was reduced noticeably(P<0. 05) and the percent of CD4+CD25+in CD4+T lymphocytes and Foxp3 expression significantly in-creased(P<0. 01) in a dose dependent way(P<0. 05). The UCB CD4+T lymphocytes cocultured with UCMSCs with DXM-inducing for 7 days,the apoptosis rate was significantly lower than that of the control group without UCMSCs (P<0. 01). These effects were partially attenuated in transwell coculture but could not be eliminated. Conclusion: UCMSCs are negative effect on UCB CD4+T lymphocytes-mediated immunity effects,and mainly manifested in the regulation on cell proliferate ability and differentiation rather than promoting apoptosis.

Objective To report the experience and results in comparing laparoscopic radical nephrectomy (LRN) and open radical nephrectomy (ORN) in the treatment of clinical T_2 stage renal cell carcinomas. Methods Between Feb. 2004 and Jul. 2007, 30 patients (12 females and 18 males with average age of 58.0±8.5 years, range 42-68 years) received LRN and 36 patients (16 females and 20 males with average age of 60.0±9. 0 years, range 52-70 years) received ORN. The average tumor sizes in the LRN and ORN groups were (8. 5±2.2)cm (range 7-12 cm) and (8. 8±2.1)cm (range 7-14 cm) respectively. Renal cell carcinoma was histopatologically confirmed in all the patients of these 2 groups after surgery. Results The operative time in the ORN group (130±27 min) was significantly shorter than that in the LRN group (176±23 min), P<0. 01. The estimated blood loss in the LRN group (200±80 ml) was also significantly less than that in the ORN group (380±185 ml) , P<0. 01. Patients in LRN group experienced significantly earlier bowel function recovery (P<0. 01) and shorter duration of drainage (P<0. 01) than those in the ORN group after operation. No severe perioperative complications occurred in all patients. The follow-up range was 6-27 months (average 15±2 months). During the follow-up, 2 patients in the LRN group developed lung metastasis. In the ORN group, 2 patients developed liver metastasis and 1 developed lung metastasis. Conclusion LRN has the advantages of minimal invasiveness and rapid postoperative recovery comparable to those of ORN, and it might be an alternative treatment option for the clinical T_2 stage renal cell carcinomas.

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.

We investigated the roles of the crude antigen(CA) of Clonorchis sinensis and excretory secretory products (ESPs) in the polarization of Th1 and Th2 cells.Bone marrow-derived cells were generated from BALB/c mice and isolated into immature DCs;immature DCs were then treated with either CA (CA stimulated group),ESPs (ESPs stimulated group),LPS (positive control group) or PBS (negative control group) for 24 hours.Then the CD4+T cells were isolated from mouse spleen by using anti mouse-CD4 Microbeads,and further cocultured with stimulated DCs for another 72 hours.The purities of DCs and CD4+ T cells were evaluated by flow cytometry and the expressing levels of T-bet mRNA and GATA-3 mRNA were detected by real-time PCR.ELISA was used to detect the levels of IFN-γ and IL-4 cytokines in the supernatant.mRNA levels of T-bet and GATA-3 in the ESPs group were higher than those in PBS-stimulated group (P＜0.05).The concentrations of IFN-γ and IL-4 cytokines in the culture were increased in the ESPs group,compared with PBS stimulated group(P＜0.05).IFN-γ but not IL-4 was increased in CA group (P＜0.05).The results implied that CA might play a role in Th1 type immune response,and ESPs likely play roles in both Th1 and Th2 immune responses.

Objective To build the experimental basement for the clinical use of cytokines induced killer(CIK)cells from the cord blood mononuclear cells(CBMNC)in tumor adoptive cellular immunotherapy, an effective protocol for their proliferation in vitro and cytotoxicity of CIK cells was established.Methods The lymphocytes from umbilical cord blood were isolated by density gradient centrifugation and suspended in medium with CD_3 mAb,rIL-2,rIL-1 and IFN-? as inducing agents to prepare CIK cells.At the same time, the lymphokine activated killer(LAK)and CBMNC were set as controls,which were only added IL-2 and not any cytokines during the whole culture.The changes of CIK cells before and after induction were observed with microscope and the phenotypes of the cells were analyzed by using flow cytometry.The proliferation of CIK cells were determined by trypan blue exclusion assay and the cytotoxic activity to lung cancer cell were tested with MTF method.Results According to the experiment,combining use of four types of cytokines could generate a great deal of CIK cells possessing highly cytotoxicity.From day 5 CIK cells became to prolif- erate and reached the peak at day 14.During the whole period,the relative percentage of CD_3~+ CD_(56)~+ cells in- creased significantly.Compared with LAK cells,which reached the proliferation peak at day 7 and then showed no evident proliferation.The control cells(CBMNC)showed no evident change of phenotypes and proliferation.CIK cells showed a higher antitumor activity on the tumor cells than LAK cells and CBMNC in vitro.Conclusion Umbilical cord blood can generate a great deal of CIK cells combining used with cy- tokines.Compared with classic LAK cells,umbilical cord blood CIK cells have the advantages of rapid prolif- eration speed and powerful cytotoxicity.CIK cells will be promising as a new strategy for the adoptive cellular immunotherapy of tumor.

Objective:To investigate the factors affecting the intrahepatic infection after percutaneous radiofrequency ablation(PRFA)for liver cancers.Methods:The clinical data of 1567 patients with intrahepatic infection after PRFA for liver cancers(from Dec.1999 to Oct.2007)were retrospectively summarized.Logistic regression method was used to analyze the possible affecting factors.Results:Twenty-eight person-times of intrahepatic infection occurred in 1635 patients who received a total of 2035 times of PRFA.with the infecting rate being 1.38%.The intrahepatic infection-related mortality was 0.13% (2/1567).Univariate analysis indicated that the intrahepatic infection was significantly correlated with metastatic liver cancer, pattern of past abdominal operation,tumor location,tumor size and tumor numbers(P

Objective To assess the effect of protein kinase B(PKB)on the learning and memory functions of mice with chronic lead exposure. Methotis Since the first day after birth,50 Kunming mice were randomized into 5 groups(n=10)and exposed to a 6-week acetic lead exposure at the concentrations of 1.2,2.4,4.8,7.2,and 9.6 mmol/L administered in the drinking water,with another 10 having normal water as the control group.After the 6-week exposure.water maze test Was performed to assess the spatial learning and memory abilities of the mice.The total PKB(t-PKB) and phosphorylated PKB(p-PKB)in the cortical brain neurons were determined with Western bloRing.Results The mean latency of finding the platform in the lead exposure groups was significantly higher than that in the control group(P＜0.05).Chronic acetic lead exposure resulted in obviously impaired spatial learning and memory ability in the mice,and the severity ofthe damage was positively correlated to lead concentrations in the blood and brain tissue(r=678,P=0.000;r=0.643,P=0.000).Lead exposure caused a significant dose-dependent reduction in P-PKB level in the cortical neurons,and p-PKB level in the cortical neurons was inversely correlated to blood lead concentrations(r=0.820,P=0.028) and to the spatial learning and memory ability(r=-0.671,p=000).The level of t-PKB in the cortical brain neurons showed no significant changes in response to lead exposure. Conclusion Chronic acetic lead exposure can impair the learning and memory functions of mice possibly in association with reduced content of p-PKB in the cortical brain neurons.

OBJECTIVE: The purpose of this study is to analyze the development of musicality in children after cochlear implantation, and provide a clinical database for the evaluation of their musicality. METHOD: Twenty-six children with cochlear implants (CI group) participated in this research. They received cochlear implants at the age of 11 to 68 months with a mean of 35.6 months. Seventy-six infants as a control group aged from 1 to 24 months with a mean of 6.1 months participated in this study, whose hearing were considered normal by passing the case history collection, high-risk registers for hearing loss and hearing screening using DPOAE. The music and young children with CIs: Musicality Rating Scale was used to evaluate their musicality. The evaluation was performed before cochlear implantation and 1, 3, 6, 9, 12, 24 months after cochlear implantation for children with cochlear implants. The evaluation was also performed at 1, 3, 6, 9, 12, 24 months for children with normal hearing. RESULT: The mean scores of musicality showed significant improvements with time of CI use for CI group (P<0.05). The mean scores of musicality also showed significant improvements with time for control group (P<0.05). There were no significant differences in mean scores between CI group and control group at 1, 3, 6, 9, 12 months of hearing age by rank sum test (P>0.05). Significant difference was noted between the two groups at 24 months (P<0.05). CONCLUSION The musicality of children with cochlear implants improved significantly with time after cochlear implantation. The most rapid growth was found in the first year after cochlear implantation.
Child Development ; Child, Preschool ; Cochlear Implantation ; Female ; Humans ; Infant ; Male ; Music ; Postoperative Period

OBJECTIVETo study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture.

METHODSTwenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm.

RESULTSThe incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good.

CONCLUSIONThe application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

Adolescent ; Adult ; Bone Plates ; Collateral Ligaments ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Thumb ; injuries ; surgery ; Young Adult