With the development of spinal surgery technology， improving the accuracy of surgery， minimizing the trauma of surgery， and individualization of surgical plans have become the hot spot for the future development of spinal surgery. How to obtain the maximum surgical effect with the smallest trauma， how to reduce the amount of radiation that the patient bears during the operation， and how to shorten the operation time while maintaining the effect of the operation are issues that require further attention. Currently， as a research hotspot in the field of spinal surgery， virtual reality technology becomes more and more relevant. It has shown its advantages in various aspects such as training of operation technique， teaching of theoretical knowledge， intraoperative assistance， and postoperative rehabilitation. However， the current application of virtual reality technology in spinal surgery is still in its infancy. This article attempts to review the application of virtual reality technology in spinal surgery simulation training， intraoperative assistance， and pain treatment， summarizeits application status， and discuss the future of its development， providing insights to promote the integration of the medical practice and engineering technology.

Calcinosis ; pathology ; surgery ; Child ; Diagnosis, Differential ; Humans ; Knee ; Male ; Skin Diseases ; pathology ; surgery

OBJECTIVETo evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).

METHODSA retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.

RESULTSOverall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.

CONCLUSIONFor IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Child ; Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; microbiology ; Humans ; Mycoses ; drug therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy,safety,and potential benefits of neoadjuvant intraperitoneal chemotherapy(NIPC)in patients with newly diagnosed advanced ovarian cancer.METHODS: From December 2011 to December 2015,in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,27 patients with stage ⅢC-Ⅳ ovarian cancer were enrolled in the study.NIPC was used as the initial treatment.The regimen was paclitaxel(T)intravenous chemotherapy combined with cisplatin/carboplatin(P/C)intraperitoneal chemotherapy.The primary endpoint were complication and toxicity.Secondary endpoints were progression-free survival(PFS)and overall survival(OS).RESULTS: Nine patients completed 3 times of NIPC,7 had once and 7 had twice.Nine patients completed NIPC,18 patients discontinued,includeding disease progression(n=3),patient refusal(n=3),unknown reason(n=3),myelosuppression(n=2),nephrotoxicity(n=2),arrhythmia(n=2),abdominal pain(n=1),diarrhea(n=1),and headache(n=1);there was no treatment-related death.Fourteen accepted intermittent cytoreduction surgery,and 13 were R0.There were 13 patients without surgery,of whom 4 progressed,3 gave up,and 6 had negative CA125.The median follow-up time was 36 months(10-82 months),the median follow-up time was 53.8±5.59 months,the 3-year OS rate was 57.2%,and the median PFS was 20 months(0-82 months);the 3-year PFS rate was 24.7%.CONCLUSION: It is safe and feasible to use NIPC for neoadjuvant chemotherapy in patients with advanced ovarian cancer.It may improve the satisfactory operation rate and prolong survival.

In order to understand the effect of hematopoietic stem cell mobilization agents, G-CSF and GM-CSF, on the expression of TNF-alpha mRAN and CD69 and secretion of IgG in SLE patients' peripheral blood mononuclear cells (PBMNC), expression of TNF-alpha mRNA and CD69 was measured by RT-PCR and flow cytometry, respectively, and IgG secretion by ELISA. The results showed that 0.1 - 2.0 microg/ml G-CSF did not affect the expression of TNF-alpha mRNA in active and static patients' PBMNC treated with 0.1 - 2.0 microg/ml cytokines, and 2.0 microg/ml GM-CSF increased the expression of TNF-alpha mRNA in active patients' PBMNC. G-CSF and GM-CSF did not interfere the expression of CD69 in active and static patients' PBMNC, however, the expression of CD69 was significantly increased in active patients' PBMNC treated with GM-CSF at more than 8 microg/ml. There was no obvious change of IgG secretion from PBMNC induced with 10 microg/ml G-CSF, while the IgG secretion was stimulated by 10 microg/ml GM-CSF. It was concluded that G-CSF as a mobilization agent could be safe to SLE patients, but GM-CSF may cause some harmful effects to patients because of the increase of the parameters relating to activity of lupus in active SLE patients.
Antigens, CD ; analysis ; Antigens, Differentiation, T-Lymphocyte ; analysis ; Dose-Response Relationship, Drug ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Immunoglobulin G ; biosynthesis ; Lectins, C-Type ; Leukocytes, Mononuclear ; immunology ; Lupus Erythematosus, Systemic ; immunology ; RNA, Messenger ; analysis ; Tumor Necrosis Factor-alpha ; genetics

ObjectiveTo investigate the quality of life (QOL) of the epilepsy patients and the factors affected the QOL.Methods200 cases were investigated using the Quality of Life in Epilepsy Inventory 10 (QOLEI-10) and the Washington Psychosocial Seizure Investigate (WPSI). 200 healthy persons were chosen as normal control group. ResultsThe QOL of the patient group were significantly poor as compared with that of normal control group(P<0.01). The factors that the patients always faced with were disability in the attack control, short in money, unemployment, restriction of movement, disability in intercommunication, psychological disorder (depress, strain, anxiety, dread, shame feel, cognitional dysfunction, etc.), as well as the difficult to get professional curtains, taking medicine improperly and side effects of the medicine. Conclusions The factors mentioned, which were usually neglected by many doctors, do affect the QOL of epilepsy patients, and hinder the epilepsy treatment effectively.

Objective To explore the problems of microsurgical treatment of multiple intracranial aneurysms with regard to the indications,surgical timing,operative approaches and the prevention of complications, and improve their diagnoses and treatments. Methods We retrospectively reviewed the data of 33 patients with multiple intracranial aneurysms admitted to our hospital from Jan.2000 to Dec.2008 and their clinical manifestations,imaging features and microsurgical treatments were summarized. Results In the 33 cases of multiple intracranial aneurysms,the male-to-female sex ratio was 1:1.75 and the average age at onset of symptoms was 56.52.Twenty-four patients showed good postoperative prognosis(Glasgow Outcome Scale IV-V) with 2 deaths.Conclusion Individual treatment should be adopted in the treatment of differently localized multiple intracranial aneurysms with different sizes and clinical classifications,and the utilization of temporary blockade and ultrasound during the operation can improve the therapeutic effects and reduce the postoperative complication rates.

OBJECTIVETo investigate the effects of different anesthesia methods on immune surveillance and tumor metastasis in tumor-bearing rats.

METHODSSeventy-two Fischer 344 rats were randomly assigned into 3 equal groups and anesthetized for 1 h with ketamine (group K), propofol (group P), or neuraxial block (group B). All the rats were subjected to laparotomy followed by intravenous injection of MADB106 tumor cells, and 24 h after the injection, the number and activity of circulating CD3(+), CD4(+), CD8(+), and D4(+)/CD8(+) lymphocyte subsets and NK cellèCD161a(+)éwere assessed. Three weeks later, the lung metastases were counted.

RESULTSCompared with those in group B, the numbers of CD3(+), CD4(+), CD8(+), and CD161a(+) lymphocytes and the activity of circulating NK cells were significantly reduced, and the lung metastases of MADB106 increased significantly in groups K and P (P<0.05 or 0.01 ). The activity of immune surveillance in group K was significantly lower than that in group P except for CD8(+) cells, and the tumor metastases in group K increased significantly in comparison with those in group P (P<0.05 or 0.01).

CONCLUSIONNeuraxial block provides protection of the activity of immune surveillance and reduces tumor metastases in tumor-bearing rats compared with general anesthesia.

Anesthesia, Epidural ; adverse effects ; Anesthesia, General ; adverse effects ; Animals ; Breast Neoplasms ; immunology ; surgery ; Female ; Immunologic Surveillance ; immunology ; Ketamine ; pharmacology ; Lung Neoplasms ; immunology ; secondary ; Male ; Neoplasm Metastasis ; Neoplasm Transplantation ; Nerve Block ; Propofol ; pharmacology ; Random Allocation ; Rats ; Rats, Inbred F344

OBJECTIVETo introduce the METRx microendoscopes diskectomy system in the treatment of far lateral lumbar disc herniation.

METHODSFourteen cases of far lateral lumbar disc herniation were operated with METRx from February 1999 to December 2002. Among them, the average age was 49 years old (range 41 - 55 years old), male in 10 cases, female in 4 cases. All cases were single disc herniation; L(4), 5 herniation in 6 discs, L(5)-S(1) herniation in 8 discs; foraminal disc herniation in 6 cases, extra-foraminal disc herniation in 8 cases.

RESULTSAll the cases were followed up from 12 to 46 months (average 26.5 months) with the results of excellence in 10 cases, good in 3 cases, fair in 1 case and no failure case. There were no disc infection, dura laceration, nerve root injury and herniation recurrence.

CONCLUSIONSMETRx is suitable for far lateral lumbar disc herniation with the advantages of minimal invasive, complete decompression of nerve root and rapid recovery. The correct approach and precise surgical technique are the key points for this operation.

Adult ; Diskectomy ; methods ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Microsurgery ; Middle Aged ; Treatment Outcome

To investigate whether masticatory fatigue affects the fracture resistance and pattern of lower premolars restored with quartz-fiber post-core and full crown, 44 single rooted lower premolars recently extracted from orthodontic patients were divided into two groups of 22 each. The crowns of all teeth were removed and endodontically treated and then restored with quartz-fiber post-core and full crown. Twenty-two teeth in one group were selected randomly and circularly loaded at 45° to the long axis of the teeth of 127.4 N at a 6 Hz frequency, and the other group was not delivered to cyclic loading and considered as control. Subsequently, all teeth in two groups were continually loaded to fail at 45° to the long axis of the teeth at a crosshead speed of 1 mm⋅min(-1). The mean destructive force values were (733.88±254.99) and (869.14±280.26) N for the experimental and the control group, respectively, and no statistically significant differences were found between two groups (P>0.05). Bevel fracture and horizontal fracture in the neck of root were the major fracture mode of the specimens. Under the circumstances of this study, it seems that cyclic loading does not affect the fracture strength and pattern of the quartz-fiber post-core-crown complex.
Acid Etching, Dental ; methods ; Adult ; Bicuspid ; Bite Force ; Chromium Alloys ; chemistry ; Crowns ; Dental Prosthesis Design ; Dental Restoration Failure ; Dental Stress Analysis ; instrumentation ; Humans ; Materials Testing ; Methacrylates ; chemistry ; Phosphoric Acids ; chemistry ; Post and Core Technique ; instrumentation ; Quartz ; chemistry ; Resin Cements ; chemistry ; Stress, Mechanical ; Tooth Fractures ; physiopathology ; Tooth Root ; injuries ; Tooth, Nonvital ; rehabilitation