OBJECTIVETo evaluate the clinical outcomes of percutaneous intervertebral foramina endoscopic lumbar discectomy for elder patients with lumbar spinal stenosis syndrome.

METHODSFrom July 2006 to July 2011, 60 elder patients with lumbar spinal stenosis syndrome were treated with surgical operation, including 32 males and 28 females with an average age of (66.7 +/- 2.5) years old ranging from 72 to 83 years. These patients were divided into the traditional surgery group and percutaneous intervertebral foramina endoscopic discectomy groups (PTED group), 30 cases in each group. The index of the preoperative and postoperative, operative incision visual analogue scale (VAS) of two groups were compared. The Oswestry disability index (ODI) of two groups at 6, 24 months of the follow-up were also evaluated on activity of daily living.

RESULTSThe average operative time, the average blood loss, the number of cases using analgesic drug, hospitalization time of PTED group were better than those of the traditional surgery group (P < 0.05). The improvement of incision VAS in PTED group was better than that in the traditional surgery group (P < 0.05). All patients were followed up for 24 months at least. The ODI at 1, 24 month after operation were better than that of preoperative in two group respectively (P < 0.05), but the improvement of PTED group was better than that of the traditional surgery group (P < 0.05).

CONCLUSIONPTED has the advantages of smaller incision, less bleeding, less postoperative stay and hospitalization time, tissue trauma and quicker recovery. It is a safe and efficacious minimally invasive surgical technique for elder patients with lumbar spinal stenosis syndrome.

Aged ; Aged, 80 and over ; Decompression, Surgical ; Diskectomy, Percutaneous ; Endoscopy ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Spinal Stenosis ; surgery ; Treatment Outcome

Objective To investigate the clinic characters and diagnosis of superficial siderosis in the central nervous system (SSCN).Methods One patient was systematically studied by the authors. Results SSCN was a rare entity,resulting in the deposition of ferric pigments and ions on the surface of the central nervous system.The clinical features included progressive sensorineural hearing loss,cerebellar ataxia and pyramidal sign,widespread hypointensity band at surfaces of the cerebral or cerebellar hemispheres,the brain stem and the spinal cord on Gradient Echo T_2~*-weighted images (GRE-T_2~* WI) of MR,elevation of the levels of ferritin in the cerebrospinal fluid.Conclusions This disease can be identified at early stage with history and physical examination.GRE-T_2~* WI and some related cerebrospinal fluid tests will contribute to diagnosis.

BACKGROUNDIt is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms.

METHODSWe reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was (59.2 ± 12.5) years and the mean left ventricular ejection fraction was (57.4 ± 11.0)%. All patients were followed up completely for a period of 12 to 51 months (mean, (33.1 ± 11.2) months).

RESULTSFifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting (n = 7), aortic valve replacement (n = 3), mitral valve replacement (n = 3), mitral valve replacement with coronary artery bypass grafting (n = 1) and left atrial myxoma resection (n = 1). Neoplastic resection consisted of lung cancer resection (n = 5), colonic cancer resection (n = 3), gallbladder resection (n = 1), colonic cancer resection with gallbladder resection (n = 1), hysterectomy (n = 2), hysterectomy with bilateral salpingo-oophorectomy (n = 2) and left ovariectomy (n = 1). Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation (33.3%), pneumonia (26.7%), low cardiac output syndrome (6.7%) and delayed healing of surgical wounds (6.7%). There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% (Kaplan-Meier method).

CONCLUSIONSSimultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality. Cardiopulmonary bypass does not appear to adversely affect survival in patients with malignant disease. The long-term survival was determined by tumor stage.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Female ; Heart Diseases ; surgery ; Humans ; Hysterectomy ; adverse effects ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Ovariectomy ; adverse effects ; Thoracic Surgery ; statistics & numerical data ; Treatment Outcome

This study aims to investigate whether the nucleoprotein (NP) of severe fever with thrombocytopenia syndrome virus (SFTSV) can impact the cellular immunity of host cells. Gene segments that encode the NP and non-structural protein (NSs) of SFTSV were inserted into eukaryotic expression vector VR1012. Host proteins that interact with NP and affect immunity were identified with co-immunoprecipitation (IP), SDS-PAGE, mass spectrometry (MS), and Western blot. Co-localization of NP and the identified host proteins was confirmed by confocal microscopy. A 60kD SSA/Ro, a protein related to immunity, interacted with NP, as found by IP and MS. Confocal microscopy showed that NP and SSA/Ro were co-localized in cytoplasm. These results indicated that SFTSV NP may specifically bind to 60kD SSA/Ro and cause a series of immune responses and clinical symptoms.
Bunyaviridae Infections ; genetics ; metabolism ; virology ; HEK293 Cells ; Humans ; Nucleoproteins ; genetics ; metabolism ; Phlebovirus ; genetics ; metabolism ; Protein Binding ; Ribonucleoproteins ; genetics ; metabolism ; Viral Proteins ; genetics ; metabolism

Viral hemorrhagic fevers (VHFs) refer to a group of acute infections with high case fatality rates that are caused by four distinct families of RNA viruses belonging to the families Bunyaviridae, Flaviviridae, Filoviridae and Arenaviridae, the main clinical symptoms of these diseases are accompanied by fever and bleeding. For the reason that these infections have similar primary clinical symptoms, it is difficult to diagnose and distinguish them; rapid and reliable laboratory diagnostic tests are required in suspected cases for epidemiological investigation and controlling the spread of VHFs. This review addresses the laboratory diagnostics of VHFs, covering etiological classification and different diagnostic techniques, such as virus isolation, nucleic acid detection, as well as antigen and antibody assays. Prospects for novel diagnostic tools are also discussed.
Clinical Laboratory Techniques ; methods ; Hemorrhagic Fevers, Viral ; diagnosis ; immunology ; virology ; Humans ; RNA Viruses ; genetics ; immunology ; isolation & purification

OBJECTIVETo explore clinical outcomes and advantages of anterior small-incision focus debridement with posterior internal fixation through muscle spa ring in treating patients with lumbar spinal tuberculosis.

METHODSFrom February 2010 to February 2014, totally 82 patients with lumbar spinal tuberculosis were treated by posterior individual fixation with small-incision focus debridement,including 50 males and 32 females with an average of 50.5 years old. All patients were divided into two groups according to different procedures. Forty-nine patients in group A were treated with anterior small-incision focus debridement with posterior internal fixation through muscle spa ring at stage I ; and 33 patients in group B were treated with focus debridement with posterior internal fixation by extraperitoneal approach at stage I . Postoperative mechanical ventilation time, preoperative and postoperative Cobb angle, visual analogue scale (VAS), erythrocyte sedimentation rate (ESR) and Frankel grading were observed and compared. Postoperative complications, stability of internal fixation and bone union were compared.

RESULTSAll patients were followed-up from 15 to 36 months with an average of 23.7 months. Psoas abscess of three patients in group A and 1 patient in group B on the opposite side increased and were healed by the secondary apocenosis. The other 78 cases were healed at stage I, and no sinus tract formation, incisional hernia, leakage of cerebrospinal and occurrence of spinal tuberculosis were occurred. Fracture healing time ranged from 3 to 7 months with an average of 4.6 months. Postoperative mechanical ventilation time and VAS score in group A was better than group B. There were no statistical differences in Cobb angle, ESR and Frankel grading at the final following-up between two groups.

CONCLUSIONAnterior small-incision focus debridement with posterior internal fixation through muscle spa ring in treating patients with lumbar spinal according to degree of damage is a safe and effective method.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Debridement ; methods ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Treatment Outcome ; Tuberculosis, Spinal ; surgery ; Young Adult

To raise the syndrome sequence quantification, differentiation and classification algorithm based on data envelopment analysis for solving the modeling issue of syndrome differentiation and classification of traditional Chinese medicine (TCM). This algorithm has three steps: first, in order to obtain basic units for explaining pathogenesis, and establish a syndrome collection on this basis mechanisms of syndrome differentiation and classification were analyzed and classified according to TCM theory, mechanisms of syndrome differentiation and classification were analyzed and classified according to TCM theory; second, regularity and syndromes of corresponding prescriptions were sought according to the incidence and development progress of syndromes, and mathematical tools of data envelopment analysis were used to calculate state data of syndromes in each stage and obtain quantitative syndrome sequence; finally, syndrome sequence was taken as the measurement standard to quantify candidate syndromes and diagnostic information, and the similarity was calculated to obtain the matching degree between diagnostic information and candidate syndromes, so as to complete the syndrome differentiation and classification calculation. According to the results of model-based reasoning, the algorithm could indicate the regularity implied in prescription materials, and grasp the dynamic process of syndromes in an all-round way, and its results were verified through calculation and analysis on clinical cases. At least, it provides an idea for quantitative modeling of TCM.
Data Mining ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Models, Theoretical ; Phytotherapy

OBJECTIVETo review retrospectively the experience of surgical repair of sinus of valsalva aneurysm (SVA) in 70 patients.

METHODSBetween September, 1988 and October, 2003, Seventy patients with SVA underwent surgical repair by the aid of general anesthesia and cardiopulmonary bypass, comprised 1.4% (70/4960) of all open-heart operation. Forty-five were male and 25 female. Age ranged from 3 to 69 years old [mean (29 +/- 15) years]. The aneurysms ruptured into the right ventricle in 46 patients, right atrium in 23 and left ventricle in 1 respectively. The aneurysms originated from right and noncoronary sinus in 61 patients (87%) and 9 patients (13%) respectively. The most common associated cardiovascular lesions were ventricular septal defect (VSD, n = 34) and aortic valve incompetence (n = 21). Repairs were achieved through an incision in right atriotomy, right ventriculotomy or aortotomy only or both aortotomy and right atriotomy (or right ventriculotomy). The defects in the sinus of valsalva was repaired with either direct sutures (n = 43) or a patch (n = 27). The aortic valve was replaced in 6 patients.

RESULTSThere were no deaths in early time after repair. Postoperative hospital stay was 8 approximately 33 days [mean +/- standard deviation, (14.3 +/- 6.4) days] before 1997 and 6 approximately 15 days [mean +/- standard deviation, (9.1 +/- 2.6) days] after 1997 respectively. Complications included infection (n = 4), hemorrhage (n = 4), pneumothorax (n = 1), arrhythmia (n = 4) and residual shunt (n = 1) of VSD. Fifty-three (76%) patients (2 months approximately 13 years) were followed-up [mean +/- standard deviation, (6.6 +/- 3.8) years]. All patients survived except that one died of rupture of dissecting aortic aneurysm 7 years after operation.

CONCLUSIONSThe ruptured sinus of valsalva aneurysm and unruptured sinus of valsalva aneurysm with ventricle septal defect or(and) aortic valve regurgitation should be repaired surgically as soon as the diagnosis was confirmed. Long-term results are associated with preoperative aortic valve regurgitation.

Adolescent ; Adult ; Aged ; Aortic Aneurysm ; complications ; surgery ; Aortic Rupture ; surgery ; Aortic Valve Insufficiency ; complications ; surgery ; Child ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; complications ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sinus of Valsalva ; surgery ; Treatment Outcome

OBJECTIVETo compare and evaluate the effect of autologous cancellous bone and cancellous bone enriching bone marrow stem cell for the repairing the defects of articular cartilage, and purpose the experimental basis for clinical application.

METHODSBy using the completely random design, 16 adult rabbits were divided into two groups randomly. Autologous cancellous bone and cancellous bone enriching bone marrow stem cells were applied for repairing size-matched, full-thickness articular cartilage defects on the femoral condyle of the knees. The reconstructed tissues were observed by gross, optical and microscopy view and Wakitani score at 12 weeks respectively.

RESULTSIn cancellous bone enriching bone marrow stem cells group, articular surface was ivory white and relative evenness, the regenerated tissues integrated well with the surrounding normal cartilage with obscure boundary between them. The thickness of regenerated tissues was two-third of normal cartilage, the Wakitani score was 4.44 +/- 1.41. In autologous cancellous bone group, articular surface was gray and introcession, the regenerated tissues was very thin, the thickness of regenerated tissues was one thirds or one half of normal cartilage, the Wakitani score was 8.93 +/- 1.18. The differences between two groups were significant (P < 0.01).

CONCLUSIONCancellous bone enriching bone marrow stem cells are feasible for repairing of large articular cartilage defects with hyaline cartilage. The repairing ability of autologous cancellous bone is inferior.

Animals ; Bone Marrow Cells ; cytology ; Bone Transplantation ; Cartilage, Articular ; injuries ; surgery ; Female ; Male ; Rabbits ; Stem Cell Transplantation ; Transplantation, Autologous

OBJECTIVETo explore the molecular mechanism via which the chemotherapeutic drug hydroxyurea (HU) enhances K562 cell apoptosis induced by tumor necrosis factor-related apoptosis-inducing ligand (TRAIL).

METHODSChronic myelogenous leukemia-derived K562 and SVT-35 cells were treated with recombinant soluble TRAIL (rsTRAIL) alone or combined with HU for a time course, and the cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-4-sulfophenyl-2H-tetrazolium-phenazine methosulphate assay. Western blot was performed to analyze the activation of apoptosis-related protein kinases and the expression of apoptosis inhibitor molecules.

RESULTSThe survival rates of SVT-35 and K562 cells treated with 1 μg/ml rsTRAIL for 24 hours were 32% and 93%, respectively. HU significantly increased the sensitivity of K562 cells to rsTRAIL cytotoxicity. Combination of rsTRAIL and HU resulted in the phosphorylation of rat sarcoma (RAS), mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK), extracellular signal-regulated kinase (ERK), and c-Jun N-terminal kinase and in the significant reduction of apoptosis-inhibited molecule Fas associated death domain protein-like interleukin-1 beta-convening enzyme inhibitory protein and cellular inhibitor of apoptosis protein-1 in K562 cells.

CONCLUSIONSHU enhanced K562 cell sensitivity to rsTRAIL is mediated by Ras-MEK-ERK signaling pathway. Expression of antiapoptotic proteins cellular Fas associated death domain protein-like interleukin-1 beta-convening enzyme inhibitory protein and cellular inhibitor of apoptosis protein-1 is also down-regulated during this process. These results may through light on the therapeutic study of human chronic myelogenous leukemia.

Apoptosis ; drug effects ; physiology ; CASP8 and FADD-Like Apoptosis Regulating Protein ; metabolism ; Humans ; Hydroxyurea ; pharmacology ; Inhibitor of Apoptosis Proteins ; metabolism ; K562 Cells ; MAP Kinase Signaling System ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology