Objective To compare the clinical outcomes of modified and traditional posterior lumbar interbody fusion (PLIF) in treatment of lumbar spinal stenosis.Methods A retrospective review was made on 47 patients who sustained monosegmental L4.5 stenosis due to lumbar degenerative revise and characterized by typical intermittent claudication and single or both limb numbness and pain.The patients were randomly allocated to Group A and Group B using the lottery method.Group A (n =24) consisted of 10 males and 14 females at mean age of 52 years (range,47-66 years) and the course of disease averaged 13 months (range,9-23 months).Group B (n =23) contained 8 males and 15 females at mean age of 53 years (range,49-67 years) and the course of disease averaged 11.5 months (range,6-22months).Modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction and interbody fusion was performed in Group A.Traditional PLIF,namely posterior spinal decompression and interbody fusion,was performed in Group B.Waist function rehabilitation after surgery of the patients in the two groups was assessed using the Oswestry disability index (ODI) and postoperative results were analyzed.Results There were no significant differences between Groups A and B regarding the operation time [(1 90 ± 15.66) min vs (170 ± 11.32) min] and intraoperative blood loss [(980 ± 35.58) ml vs (879 ± 21.25) ml] (P ＞ 0.05).Mean period of follow-up was 20 months (range,12-28 months).Postoperative results in Group A were graded as excellent in 19cases,good in three,fair in two and poor in zero,with excellence rate of 88％.While in Group B,the results were excellent in 13 cases,good in four,fair in four and poor in two,with excellence rate of 74％(P ＜ 0.05).ODI score and symptom improvement rate after operation were better in Group A than in Group B (P ＜ 0.05).Conclusion The modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction is relatively an ideal surgical technique for treatment of lumbar spinal stenosis and deserves wide promotion.

Objective To analyze the relation between calcium and phosphate metabolism and the death for cardiovascular disease in continuous peritoneal dialysis patients.Methods60 peritoneal dialysis patients from our hospital were collected from July,1999 to December,2007 were divided into two groups by the death causes:the death cause for CVD group and the death cause for non-CVD group,and then compare their gender、age、time for dialysis、difference for pulse pressure(PP)、the content of Ca、P、Ca?P and PTH in serum.Results There are 28 cases in CVD group(47%);there are 32 cases in non-CVD group(53%).There are not differences for age、gender、time for dialysis and serum calcium between two groups;there are significant differences for PP、serum phosphorus、Ca?P、PTH between two groups.ConclusionThe high value for phosphorus、Ca?P and PTH in serum are closely related to the death cause for CVD in continuous peritoneal dialysis patients,which are the main dangerous factors in the death cause for CVD.

OBJECTIVEThe purpose of this study was to establish two-dimensional magnetic field finite element analysis model of cup-yoke-type magnetic attachment for optmizing the design of magnetic attachments.

METHODSBecause the magnetic field of cup-yoke-type magnetic attachment is stable axial-symmetrical, the authors only analyzed two-dimensional magnetic field of 1/2 section. The Maxwell stress between magnet and keeper was integral analyzed using the finite element method, and the attractive force between magnetic attachments was obtained.

RESULTSCompared the value of calculated attractive force with that of examined, the authors found that the procedure veritably reflected influencing trend of variable factors on attractive force, and the value of former one was 10% less than the later one.

CONCLUSIONThis procedure can be used in magnetic field calculation of cup-yoke-type magnetic attachments.

Computer Simulation ; Dental Prosthesis, Implant-Supported ; instrumentation ; Denture Retention ; instrumentation ; Finite Element Analysis ; Humans ; Magnetics ; Models, Biological ; Stress, Mechanical

Objective To describe the hemodynamic characteristics of normal pancreas and pancreatic tumors by 64 slices helical CT perfusion imaging, to evaluate the role of CT perfusion in the diagnosis of pancreatic tumors. Methods Perfusion CT scan was performed in 149 patients, including 36 patients with normal pancreas, 105 patients with pancreatic tumors and 8 patients with duodenal papillary carcinoma. The parameters including blood flow (BF) ,blood volume (BV) and permeability surface area product (PS) were measured. Results The mean value of BF, BV and PS of normal pancreas were (135.24±48.36) ml· min-1·kg-1, (200.55±54.96)ml/kg and (49.75±24.27) ml·min-1·kg-1, respectively. Pancreatic carcinoma has a lower BF, BV and PS,whieh were 31.77±19.36 ml·min-1· kg-1, (66.84±39.49)ml/kg and (37.64±27.14) ml·min-1·kg-1, respectively. The aforementioned parameters in pancreatic cysts were close to zero. The parameters in pancreatic carcinoma were significantly lower than those in normal pancreas(P<0.05); the BF and BV in duodenal papillary carcinoma were significantly lower than those in normal pancreas(P<0.05), while the value of PS was not significantly different from that in normal pancreas; the aforementioned parameters in pancreatic cysts were significantly different from those in normal pancreas(P <0.01). Conclusions In perfu sion CT, normal pancreas was an organ with symmetrical BF,BV and PS. Pancreatic carcinoma was a tumor with low perfusion and decreased PS. Duodenal papillary carcinoma had decreased BF and BV with no significant change in PS. Pancreatic cyst had no blood perfusion. The 64 slice helical CT peffusion imaging was invaluable in differential diagnosis of pancreatic tumors.

Objective To investigate the effects of acarbose versus fenofibrate on insulin secretion and insulin resistance in the subjects with impaired glucose tolerance (IGT) and hypertriglyceridemia. Methods Eighty subjects were allocated to acarbose group (28 cases),fenofibrate group (30 cases),and control group (22 cases) without intervention for 3 months,and also divided into elderly (46 cases) and younger groups (34 cases). Fasting blood samples were collected for measuring fasting plasma glucose and lipid.Oral glucose tolerance test (OGTT) were carried out with measurement of plasma insulin and glucose before ad after treatment.Early insulin secretion indexes(△I30/△G30),insulin secretion indexes (HOMA -β) and insulin resistance indexes (HOMA-IR)were calculated. Results After 3-months of treatment,the lipid profile was evidently improved in fenofibrate group. Levels of triglyceride (TG) and total cholesterol (TC) were significantly reduced ( both P ＜ 0.01 ),△I30/△G30 was significantly increased (P ＜ 0.05) and HOMA-IR was decreased (P＜＜0.01).In acarbose group,levels of fasting plasma glucose (FPG),2hours postprandial plasma glucose (2 hPG) and HOMA-IR were reduced (all P＜0.01),△I30/△G30 and HOMA-β were enhanced (P＜0.01 or P＜0.05).No change of above indicators was found in the control group.Compared with fenofibrate group,acarbose group had higher △ I30/△G30 (P＜ 0.05),HOMA-β (P＜ 0.01 ) and lower HOMA-IR ( P ＜ 0.01 ).The improvement of △△I30/△G30 was correlated with the decreasing of plasma FPG,2 hPG and TG(r=0.5812,0.6327,0.3872,P＜0.01),while HOMA-1R was related with the decreasing of plasma 2 hPG,TG and TC(r=0.8126,0.4671,0.2895,P＜ 0.01). HOMA-IR,△I30/△G30 and HOMA-β were lower (P＜0.01) and acarbose improved insulin resistance better (P＜0.05) in the elderly than in the younger with type 2 diabetes. Conclusions Pancreatic β-cell function declines gradually with aging,acarbose may have advantage over fenofibrate in improving early insulin secretion and resistance which was more relieved by diminishing glucotoxity in comparison with lipotoxity.

Objective To observe the effects of transplantation of bone marrow stem cells(BMSCs)transfected with bone morphogenetic protein-2(BMP-2)on fracture healing in rats with diabetes so as to provide a new therapy for diabetic fractures.Methods Fifty male adult Wistar rats aged six weeks randomized to the control group and experimental group were all employed to establish models with diabetic fractures.Under high glucose condition,BMSCs were transfected with BMP-2 by adenovirus vector in vitro.BMSCs transfected by BMP-2 were transplanted into the fracture area of rats in the experimental group,while non-transfected BMSCs into the corresponding area of rats in the control group.X-ray examination was performed at 1,2,3,4 and 6 weeks after transplantation.Bony calluses were collected for HE staining and gray scales of BMP-2 in calluses were determined by immunohistochemical method.Meanwhile,serum levels of BMP-2 were measured by ELtSA.Results The gray scales of BMP-2 in the calluses were 83±3 in the experimental group and 118±4 in the control group at four weeks(P＜0.01).The serum concentrations of BMP-2 were(203.80±8.96)ng/L in the experimental group and(139.15±4.19)ng/L in the control group at four weeks(P＜0.01).Conclusion Transplantation of BMSCs transfected by BMP-2 promotes fracture healing in diabetic rats.

Objective To discuss the application of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy ( EUS-nCLE) in the diagnosis of pancreatic neoplasms. Methods Patients with pancreatic neoplasms were diagnosed by endoscopic ultrasonography and punctured by 19 G needle, and then the confocal microprobe was implanted through the needle. The lesions nature was estimated according to obtained images. The diagnostic yield and complication was evaluated and compared with pathology. Results A total of 28 patients successfully underwent EUS-nCLE, and high quality images were obtained in all patients. The final diagnosis were 5 cases of serous cystadenoma ( SCN ) , 3 cases of mucinous cystadenoma, 3 cases of intraductal papillary mucinous neoplasms ( IPMN) , 1 case of pseudocyst, 10 cases of ductal adenocarcinoma, 1 case of neuroendocrine tumor, 2 cases of solid pseudopapillary tumor, 2 cases of chronic pancreatitis, and 1 cases of lymphoma. The diagnostic yield in 26 patients with pathology was 73. 1%(19/26) and the specificity of SCN and IPMN was 100%(7/7). The complications, mostly pancreatitis and intracystic hemorrhage, occurred in 10. 7% ( 3/28) patients. Conclusion EUS-nCLE is a safe and feasible method in the diagnosis of pancreatic neoplasms, and shows high specificity in SCN and IPMN.

Objective To summarize the efficacy of extracorporeal membrane oxygenation (ECMO)utilization in Emergency Department (ED),as well as the establishment of emergency ECMO team.Methods A retrospective analysis was carried out in 16 patients treated with ECMO between April 2015 to December 2016 in ED.The clinical data including demographics,diagnosis,initiating ECMO timing,place of ECMO establishment,intubation approaches,duration of ECMO,complications and outcomes were collected and analyzed.Results Eight patients were successfully weaned from ECMO,and 7 of them survived to discharge from hospital.The duration of ECMO support was 4 to 384 hours.The emergency ECMO team was set up.Conclusions Emergency medical team can successfully operate the ECMO process.The emergency medical team-initiated ECMO can provide effectively adjuvant measures to support patients with respiratory failure,circulatory failure and cardiac arrest.

Objective To explore the effect of first-line anti-tuberculosis treatment on vitamin D level in patients with pulmonary tuberculosis,and to master the changes of vitamin D level in the course of treatment,so as to provide a scientific basis for tuberculosis and nutrition health education in Shenzhen.Methods A total of 100 patients diagnosed as smear-positive pulmonary tuberculosis and receiving initial treatment in 2016 were enrolled and all the patients were treated with the standardized short-course chemotherapy regimens.The blood samples were extracted before treatment and at the ends of intensive and continuation phase.The 25-hydroxyvitamin D [25-(OH) D] concentrations were determined by chemiluminescence (CLIA) at each time point.The change of 25-(OH) D concentrations during anti-tuberculosis treatment was analyzed and the differences of vitamin D levels between different time points were identified.Results 79 (79.0％),94 (94.0％) and 96 (96.0％) patients were found vitamin D deficiency before treatment and at the end of the intensive and continuation phases respectively,which showed an upward trend (x2=15.543,P＜0.001) and the 25-(OH)D concentrations were (15.74±6.54) ng/ml,(12.56±5.15) ng/ml,(11.51±4.28) ng/ml,respectively.During the whole course of treatment,the 25-(OH) D concentration decreased by 26.9％ or (4.23 ± 6.75) ng/ml (t =6.257,P＜0.001),wherein it decreased (3.18 ± 5.24) ng/ml in intensive phase (t =6.069,P＜ 0.001) and (1.05±4.86) ng/ml in continuation phase (t =2.154,P =0.034).The former had a greater decreased value (t=2.836,P=0.006).There were 77 (77.0％) and 55 (55.0％) patients with 25-(OH)D concentration reduction in intensive and continuation phases respectively (x2 =9.680,P =0.003),of which 41 patients (41.0％) continued to decline.Conclusion Once anti-tuberculosis treatment is conducted,the vitamin D level will decrease rapidly in the intensive phase and continue decreasing throughout the course of treatment,which leads to a general lack of vitamin D in patients with primary pulmonary tuberculosis.First-line anti-tuberculosis drugs may be the main cause for vitamin D level reduction.Therefore,it is necessary for clinicians to strengthen vitamin D health education for each patient throughout the treatment period,especially for those at high risk of vitamin D deficiency who should be recommended adjuvant vitamin D supplementation therapy.

To explore the effects of miR-101-3p on IL-1β-induced chondrocyte injury and its underlying mechanisms.
 Methods: Chondrocytes were divided into 4 groups: a control group (NC group), a IL-1β group, a negative control group (IL-1β+miR-NC group), and a miR-101-3p group (IL-1β+miR-101-3p group), which were treated with IL-1β after transfecting with miR-101-3p mimic or negative mimic. The expressions of miR-101-3p-5p and stanniocalcin 1 (STC1) at different concentrations of IL-1β (1, 5, 10 ng/mL)-induced chondrocytes were detected by Western blotting and real-time PCR. MTT assay was used to detect cell proliferation rate, while caspases assay kits and flow cytometry were used to measure the cell caspase and apoptosis level. Western blotting assay was used to detect the expression levels of pro-inflammatory and ECM-related protein, such as matrix metalloproteinase 9 (MMP9) and collagen Type II. In addition, 3'-untranslated regions (UTR) of wild-type STC1 (STC1-3'-UTR-WT) or 3'-UTR of mutant STC1 (STC1-3'-UTR-MUT) were co-transfected with miR-101-3p mimic or miR-NC, respectively, while luciferase reporter assay was used to examine the regulative role of miR-101-3p in STC1. In order to detect whether STC1 was involved in the effect of miR-101-3p on chondrocytes, miR-NC (miR-NC group), miR-101-3p (miR-101-3p group), anti-NC (anti-NC group) and anti-miR-101-3p (anti-miR-101-3p group) were respectively transfected into the cells, and the expression of STC1 protein was detected by Western blotting. Subsequently, the cells were randomly divided into a miR-101-3P group (IL-1β+miR-101-3p group), an over-expression control group (IL-1β+miR-101-3p+ad-GFP group), and an over-expression STC1 group (IL-1β+miR-101-3p+ad-STC1 group) to investigate whether STC1 was involved in the role of miR-101-3p in chondrocyte. Similarly, MTT assay was used to detect cell proliferation rate, caspases assay kits and flow cytometry were used to measure the cell caspase and apoptosis level. Western blotting assay was used to detect the expression levels of pro-inflammatory and ECM-related protein MMP9 and collagen Type II.
 Results: Compared with the 0 ng/mL IL-1β, the expression of miR-101-3p was decreased in chondrocyte at different concentration of IL-1β (1, 5, 10 ng/mL) (all P<0.05), while the level of STC1 was increased (P<0.05). Compared with the NC group, the chondrocyte proliferation rate was down-regulated (P<0.05), while the apoptosis rate, the levels of caspases, IL-6 and TNF-α were increased in the IL-1β group (P<0.05). Moreover, the MMP9 levels were increased obviously, and the protein levels of collagen Type II were decreased in the IL-1β group compared with the NC group (both P<0.05). Compared with the IL-1β+miR-NC group, the proliferation rate was increased (P<0.05), whereas the apoptosis rates, the caspase-3/9 levels, the IL-6 and TNF-α levels were increased in the IL-1β+miR-101-3p group (all P<0.05). Then MMP9 levels were decreased obviously (P<0.05), and the protein levels of collagen Type II were increased in IL-1β+miR-101-3p group compared with the IL-1β+miR-NC group (both P<0.05). In addition, the double luciferase assay showed that the STC1 levels could be inhibited in the miR-101-3p group compared with the miR-NC group (P<0.05). STC1 levels were decreased in the miR-101-3p group compared with the miR-NC group (P<0.05), and the STC1 levels were increased in the anti-miR-101-3p group compared with those in the anti-NC group (P<0.05). The results of miR-101-3p+ad-STC1 group showed that compared with the miR-101-3p+ad-GFP group, the STC1 could reverse the effects of miR-101-3p on IL-1β-induced proliferation, apoptosis, inflammatory responses and ECM protein of chondrocytes.
 Conclusion: The regulation of miR-101-3p/STC1 signal pathway may have a role in reducing the IL-1β-induced chondrocyte injury.
Cell Proliferation ; Chondrocytes ; Glycoproteins ; metabolism ; Interleukin-1beta ; metabolism ; MicroRNAs