For more than a century,the treatment of cervical disorders has been greatly improved.The researches for the complications of cervical spine surgery have been enhanced during the same period.The objective of this paper is to summarize the progressive results of researches on the complications of cervical spine surgery through literature review.Common surgical complications include hematoma,dural tear,postoperative infection,C5 nerve root palsy,recurrent/superior laryngeal nerve injury,axial pain,etc.Rare complications such as esophageal injury,Homer's syndrome,vertebral artery injury,dysphagia and dyspnea caused by posterior upper cervical spine surgery have also been reported in recent years.The application of cervical instruments provides great support for the improvement of clinical efficacy.However,reports about the related complications also increases year by year,including implant displacement or broken,and special complications associated with cervical artificial disc replacement.Prevention and treatment of complications is the key in clinical practice.For those complications which already have relatively clear causes,such as soft tissue or spinal cannel hematoma,recurrent/superior laryngeal nerve injury,dural tear,accurate and effective operation is highly suggested.However,there's still no standard of operating process for preventing the complications (C5 nerve root palsy,dysphagia,axial pain,etc.),whose pathogeny are still unclear,and further studies are needed in the future.Instrument related complications caused by mal-operation or abnormal patient condition can be effectively controlled through correct medical procedures.Those instrument shortcomings of material or design aspects need to be improved by the auxiliary of cutting-edge technology for further improvement of the results of clinical application.

Objective To investigate effect of Irbesartan on plasma endothelin-1 (ET-1) and nitrogen monoxide (NO) in elderly patients with moderate to severe essential hypertension.Methods Forty patients with essential hypertension who were ≥60 years of age and had been treated with two or more antihypertensive drugs but whose systolic pressure were ≥160 mmHg and or whose diastolic pressure were ≥100mmHg,entered into the present study. Irbesartan 150mg daily was added to their original treatment for 6 week. ET-1 and NO were measured before and 6 week after treatment.used forty-two healthy adults as controls. Results In the treatment group,ET-1 was significantly decreased and NO was significantly increased after 6 weeks,addition of Irbesartan.As compared with controls,ET-1 of treatment group was higher both before and after addition of Irbesartan ( P

Sentinel lymph node biopsy has been generally accepted as a method for nodal staging in patients with early-stage breast cancer. Patients with negative results of sentinel lymph node biopsy can avoid axillary lymph node dissection and its adverse outcomes. With the development of technology,the in-dications of sentinel lymph node biopsy expand,but its appliance in breast cancer patients with neoadjuvant chemotherapy still remains controversial. This paper reviews the feasibility and timing of sentinel lymph node biopsy for breast cancer patients with neoadjuvant chemotherapy.

Tumor markers of breast cancer are closely related to its biological behaviors and are essential for treatment strategy making. Although traditional immunohistocbemistry(IHC) is the most commonly used molecular pathological method for tumor marker detection, it can not meet the clinical requirements for quantitative and individualized treatment. With the unique photo-physical properties of quantum dots(QDs), QDs conjugated probes have been successfully used in molecular and in vivo imaging, in the study on mechanism of drug delivery and targeted therapy and especially in the detection of tumor markers in vitro and molecular targeted diagnosis of breast cancer and individualized treatment strategy making. The technique has a broad prospect in clinical application.

Objective To investigate the role of arcuate fasciculus in conduction aphasia after ischemic stroke using magnetic resonance diffusion tensor imaging (DTI) technique. Methods Five patients with conduction aphasia after acute ischemic stroke (case group) and 5 patients without aphasia (control group) were selected. The DTI technique was used to detect the fractional anisotropy (FA) of Broca's area, Wernicke's area, and arcuate fasciculus. Results The FA values of Broca's area (0. 341 ± 0. 018 vs. 0. 295 ± 0. 060; t = 4. 533, P = 0. 045), Wernicke's area (0. 303 ± 0. 009 vs. 0. 243 ± 0. 011; t = 6. 556, P = 0. 022), and arcuate fiber bundle (0. 646 ± 0. 020 vs. 0. 541 ± 0. 009; t = 7. 343, P = 0. 018) in the left hemisphere were significantly higher compared with their mirror areas in the control group. The FA values of Broca's area (0. 315 ± 0. 015 vs. 0. 280 ± 0. 006; t = 6. 246, P = 0. 023), Wernicke's area (0. 299 ± 0. 012 vs. 0. 239 ± 0. 022; t = 4. 576, P = 0. 025), and arcuate fiber bundle (0. 226 ± 0. 016 vs. 0. 294 ± 0. 007; t = - 12. 590, P = 0. 006) in the left hemisphere were significantly higher compared with their mirror areas in the case group. There was no significant difference Broca's area (t = 1. 901, P = 0. 13) and Wernicke's area (t =2. 092, P = 0. 105) in the left hemisphere between the case group and the control group, but the FA values of arcuate fasciculus in the left hemisphere in the case group was significantly lower compared with the control group (t = 28. 393, P < 0. 001 ). Conclusions For patients with conduction aphasia after acute ischemic stroke, the arcuate fasciculus has the left-dominant lateralization. Their conduction aphasia may be associated with the reduction and break of the arcuate fasciculus.

Tumor markers have been of vital importance in cancer diagnosis and treatment.However,the sensitivity of tumor markers for early diagnosis is low and can not be widely used.Quantum dots are new fluorescent nanoparticles with unique photophysical and chemical properties,thus having a great potential impact on cancer pathogenesis,early diagnosis,targeted therapy,prognosis and monitoring by combining with tumor marker.The current research is focused on the detection of specific tumor markers or molecules based on tangible carriers such as cells and tissues.One of the most promising clinical applications would be to explore the potential of this highly sensitive labeling technique for the detecting and imagining of tumor markers in serum and other body fluids,where some progress has already been made recently.How to detect early cancer based solely on invisible carriers would be the next step of quantum dots bio-probes in clinical use,so as to develop a new detection technique with greater sensitivity,specificity,rapidity and convenience.

Objective To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in hu-mans,so as to provide a reference for its application in clinical practice. Methods The sera collected from the patients with neurocysticercosis,echinococcosis,taeniasis and healthy people,respectively,were checked by ELISA for specific IgG anti-bodies against T. solium cysticercus,as described in the instruction of the kit. Results Of the 30 patients with neurocysticerco-sis at active stage,28 showed seropositive reaction,indicating a sensitivity of 93.33%. There were no positive reactions in the 100 healthy people. Two of the 42 persons with taeniasis were seropositive with an infection rate of 4.76%. Forty-one of the 60 persons with echinococcosis showed positive reactions,suggesting that the cross reaction rate of the kit with echinococcosis was 68.33%. Conclusions The assessed ELISA kit has a reasonably high sensitivity but a poor specificity,and the cross reaction rate with echinococcosis is very high. It is urgent to improve the sensitivity and specificity of the diagnostic kit for detection of T. solium cysticercosis in China.

Objective To explore a safe dose range of spinal IMRT by comparing the cell damage in Beagles at different dose levels.Methods Thirty Beagles were randomly divided into 5 groups.The Beagle clinical model of tumor was established in the ninth and tenth thoracic spine.The Beagles were subjected to IMRT with the total doses of 0,40,50,60,70 Gy,respectively.The samples of spine were taken out from the same locum of the ninth and tenth thoracic spine at 3 month after radiation.All the samples were observed by the hematoxylin-eosin staining,and the VEGF expression in spine was evaluated by immunohistochemistry.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spine.Results The osteocytes in the spine showed reversible injury in 40 Gy group,and cell apoptosis in 50,60,70 Gy groups.Compared with 40 Gy group,the rates of lacuna were increased in 50,60,70 Gy groups(F =2.57,P ＜0.05),as well as the cell apoptotic rates(F =3.52,P ＜ 0.05) and the expression of VEGF (F =3.64,P ＜ 0.05),but there were no significant differences among 50,60,70 Gy groups (P ＞ 0.05).Conclusions The late radiotherapy response of the spine was obviously observed at 3 month after radiation,especially at 50 Gy.

Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder .This article discusses the clinical effect of the locking proximal humeral plate ( LPHP) combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients . Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification , the patients were divided into groups A (LPHP treatment, n=23, including 13 cases of three-part fractures and 10 cases of four-part fractures) and B (LPHP+anti-osteoporosis drugs, n=24, including 13 cases of three-part fractures and 11 cases of four-part fractures). Results All the patients were followed up for 14 to 38 (mean 23.6) months.The postoperative healing time was significantly shorter in group B than in group A ([96.57 ±2.59]d vs [115.91 ±2.73]d, P<0.05), and the excellence rate was remarkably higher in B than in A (91.7%vs 78.3%,P<0.05). Conclusion With the advantages of short healing time and high excellence rate , LPHP+anti-os-teoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.

Objective To evaluate catheter-directed thrombolysis via the popliteal vein in the treatment of the lower limb acute deep venous thrombosis.Methods From July 2009 to October 2010,32patients of the lower limb acute deep venous thrombosis including 3 patients with concurrent pulmonary embolism underwent uhrasound-guided catheter-directed thrombolysis via the popliteal vein.The thrombolytic catheter was inserted into thrombus,through which urokinase was infused at a dosage of 100 × 104U/d.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Results In every patient,the lower limb swell and pulomonary symptoms relieved.The circumferences between affected and normal thigh before and after the thrombolysis were(5.4 ± 1.4)cm and (1.7 ± 1.3)cm(t =9.92,P ＜0.01).The circumferences between affected and normal leg before and after the thrombolysis were(4.1 ± 1.5)cm and(1.5 ±0.7)cm(t =7.65,P ＜0.01).The venous patency score before and after the thrombolysis were(15 ± 4)and(4 ± 3)(t =7.12,P ＜ 0.01).The mean rate of venous patency was 88.21％.In the 3 patients with pulmonary embolism,thrombus was complete dissolved in 1 case and partial dissolved in 2 cases.No major complications occurred in all these patients.29 patients were followed up for 3-12 months.There were no thrombosis relapsed.Conclusions Catheter-directed thrombolysis via the popliteal vein with urokinase for acute lower limb deep venous thrombosis is safe and effective.