OBJECTIVETo explore incidence rate, influencing factors, leakage routes,and preventative measures of bone cement leakages in vertebral internal reinforcement operation including percutaneous vertebroplasty and percutaneous kyphoplasty.

METHODSFrom January 2010 to January 2012,94 patients with osteoporotic vertebral compressive fracture,vertebral metastases and vertebral hemangioma were treated by vertebral internal reinforcement operation. Among them, there were 39 males and 55 females aged 55 to 86 with an average of 69.4 years old. The reasons, types, incidence and complications of bone cement leakage were analyzed.

RESULTSTotally 21 patients (26 vertebral) occurred bone cement leakage, the main routes included basivertebral veins, and bone cortex, which mainly located on adjacent intervertebrae and around vertebral body, and most of them were asymptomatic leakage. For the treatment of OVCFs, incidence of bone cement leakage in PKP was lower than that of PVP (P < 0.05), while incidince of PVP in treating vertebral metastases was worse than in treating OVCFs (P < 0.05).

CONCLUSIONBone cement leakage is a common complication in PVP and PKP. Careful analysis before operation, cautiously monitors and grasp operation indication in operation can decrease incidence of it.

Aged ; Aged, 80 and over ; Animals ; Bone Cements ; adverse effects ; China ; epidemiology ; Female ; Fractures, Compression ; surgery ; Humans ; Incidence ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; epidemiology ; etiology ; Spinal Fractures ; surgery ; Vertebroplasty ; adverse effects

Objective To investigate the cognitive condition in patients with Duchenne muscular dystrophy (DMD). Methods Wechsler Intelligence Scale for Children IV (WISC-IV) was administered for 127 DMD patients aged 6~14 years from April, 2013 to December, 2015. The verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full-scale intelligence quotient (FSIQ) scores were analyzed. Results The FSIQ, VIQ and PIQ were (93.2±18.6), (91.5±18.9), and (96.6±19.5), respectively, which were lower than 100 in normal population (P<0.001), and higher than that of patients abroad in the previous studies (P<0.001). There were 13 patients (10.24%) whose scores of FSIQ were less than 70. The VIQ-PIQ discrepancy score was (-5.0 ± 16.6). Conclusion About 1/10 of Chinese DMD pa-tients impaire in cognitive function, which is significantly lower than that abroad. VIQ is more affected than PIQ.

Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.

Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder carcinoma,and the effective measures of prevention of the misdiagnosis.Methods We retrospectively analyzed the clinicalrecords of 52 cases with primary gallbladder carcinoma that had been treated in our hospital in 10 years,and analyzed the causes of misdiagnosis.Results Nineteen cases were diagnosed preoperatively(36.5%),while 33 cases were misdiagnosed before operation(63.5%),including misdiagnsed as cholecystolithiasisin 13 cases,gallbladder polyps in 8cases,atrophic cholecystitis in 4cases,hepatic hilar cholangiocarcinoma in 3 cases,tumor of liver in 4 cases,and Mirizzi syndrome in 1 case.There were 29 casesdiagnosed during operation(55.8%),and 4 cases misdiagnosed intratoperatively(7.7%).Misdiagnosiswas due to several reasons:complicated with other gallbladder disease,lack of distinctive clinical features of gallbladder carcinoma,over dependence on imaging methods,and not doing fast frozen section duringoperation in dubious cases.Conclusions In suspected cases with high risk of gallbladder cancer,imagingstudies should be performed,and,if necessary,invasive studies and even exploratory laparotomy should be done.Also,intraoperative rapid frozen section can result in early discovery and treatment,and is conducive to improvement of prognosis of gallbladder carcinoma.

Objective To investigate the renal expression of stem cell factor (SCF) in lupus nephritis (LN) and its correlation with disease activity and renal injury parameters. Methods Histochemical stain was used to examine all renal specimens (LN group n=34, chronic glomerulonephritis n=16, control group n=8). Hyhridization in situ and immunohistochemistry were used to detect the expression of SCF and infiltration of mast cells, macrophages , α-SMA (+) cells in renal tissues of the two groups. SPS software was used for tissue of the control group. However, they increased markedly in lupus nephritis and CGN (t=6.03～14.25, P< 0.01). But there was no significant difference between LN and CGN in SCF and mast cells in renal interstitium. Positive correlation was observed among the expression of SCF and α-SMA and the number of mast cells and macrophages (r=0.47～0.84, P<0.01) at their corresponding locations. The expression of SCF and ot-SMA and the number of macruphages were positively correlated with renal pathological active index, chronic index, albuminuria and the injury of renal interstitium (r=0.34～0.93, P<0.05 or 0.01); meanwhile, it was negatively correlated with Ccr(r=-0.39～0.61, P<0.01). There was significant correlation between SCF, macrophages and anti-dsDNA antibody, complement C3 level, SLE disease activity index (SLEDAI). The number of mast cells in renal interstitium was positively correlated with chronic indexes and the injury of renal interstitium (r=-0.86, r=0.93, P<0.01) and negatively correlated with Ccr (r=-0.56, P<0.01), but not correlated with active index and albuminuria (r=0.27, r=0.23, P>0.05). Conclusion The expression of SCF is widespread in kidney, and it is markedly eorrelated with various kinds of inflammatory cells, renal inherent cells, renal function, and urine protein levels. SCF may be an critical participant in the initiation and progression of renal injuries in human lupus nephritis.

Objective To find out the status of drinking-water-borne endemic fluorosis and the effect of preventive measures in Hebei Province,so as to provide a basis to prevent and cure fluorosis.Methods One affected county (city,district) with drinking-water-borne endemic fluorosis was sampled in every city and 10 water improvement projects were investigated in that county.Three villages were taken out in every county.The operating state of the projects,the water fluoride content,and the dental fluorosis of children aged 8-12 and skeletal fluorosis of adults were investigated in these villages.Results A total of 93 projects were investigated,among which 94.6％(88/93) were operating properly and the qualified rate(fluoride content ≤ 1.2 mg/L) of the projects was 54.84％(51/93).Among the 9 large projects,the water fluoride content of 7 projects exceeded 1.2 mg/L.A total of 23 villages with water improvement projects were investigated and only 43.4％ (10/23) of them water fluoride content were lower than 1.2 mg/L.The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.2％ (532/1601),0.74 and 5.7％ (66/1155),respectively.In the 7 villages without water improvement projects,2 of them exceeded 2.0 mg/L,but lower than and equal to 4.0 mg/L of water fluorosis and 5 of them were normal(＜ 1.2 mg/L).The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.4％ (111/332),0.72 and 2.9％ (10/350),respectively.Conclutions The qualified rate of water improvement projects of fluoride content ≤ 1.2 mg/L is low and the endemic fluorosis is still comparatively serious in Hebei Province.The progress of water improvement projects in the areas with endemic fluorosis should be accelerated and the quality of water improvement projects should be increased.

Objective To analyze epidemiological and clinical characteristics of chronic hepatitis C (CHC) patients. Methods The clinical data of 323 CHC patients were collected. The transmission modes, clinical manifestations and virological features were recorded. The liver histological change was also analyzed in 39 cases whose liver biopsy samples were available. The comparison between two groups was performed by t test. Results Among the 323 CHC patients, 135 cases (41. 8%) had history of blood or blood products transfusion. Sixty-seven cases (20. 7%) had undergone surgery and trauma operation. Nineteen cases (5. 9%) had history of Chinese medicine acupuncture. Eighteen cases (5.6%) had undergone hemodialysis. Two patients (0.6%) were infected through vertical transmission. Twenty-one cases (6. 5%) had history of intravenous drug use and two cases (0. 6%) had history of unsafe sexual contact. The possible transmission routes for the other 78 cases (24.1%)were unknown. Fourteen patients (4. 3%) were co-infected with hepatitis B virus (HBV). The major prevalent genotypes were hepatitis C virus ( HCV) genotype lb and 2a, which were 145 cases (65. 3%) and 21 cases (9. 5%) respectively. HCV viral loads were as high as 1 × 105 IU/mL in 74 cases (26. 1%) and 1× 106 IU/mL in 103 cases (36. 4%). Twenty-three patients (7.1%) developed obvious clinical manifestations. Among 39 patients undergoing liver biopsy, 14 cases (35. 9%) had hepatic inflammation activity index (HAI)≥4, six cases (15. 4%) had fibrosis stage (F) ≥3, four cases (10. 3%) had HAI≥4 and F≥3. Conclusions The most common HCV transmission modes are blood transfusion and use of blood products. However, surgery and trauma operation should be paid more attention. Besides blood transfusion, the transmission modes of intravenous drug injection, hemodialysis and traditional Chinese medicine acupuncture are increasing. The major HCV genotypes are lb and 2a. The viral loads of most patients are relatively high. Most patients infected with HCV don't show any obvious hepatitis symptoms and physical signs. However, the liver biopsy results from 39 patients suggest that most patients develop liver histological changes.

ObjectiveTo study the role and mechanism of low-dose aspirin with IFN-α in inhibiting growth and metastasis of hepatocellular carcinoma (HCC).MethodsMHCC97L cells were cultured and a metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude (nu/nu) mice.After administration of different doses of Aspirin and IFN-α for 40 days,the mice bearing xenografts in liver were killed,and the tumor volume and lung metastasis were evaluated.Cell proliferation and MMP-2 activity were measured by MTT and gelatin zymography,respectively.The expressions of VEGF and MMP-2 were measured by western blot and ELISA.ResultsCompared to the control group,there were no significant differences in the high-dose Aspirin [45 mg/(kg · d)] treated group regarding tumor volume [(1.89 ±0.88) cm3 vs (3.12±0.85) cm3,P＞0.05] and incidence of lung metastases (58.3％ vs 66.7％,P＞0.05),but the tumor volume and incidence of lung metastasis were significantly inhibited in the highdose IFN-α group [1.5 × 107/(kg · d)],the high-dose IFN-α combined with high-dose Aspirin group,and the low-dose IFN-α [7.5 × 106 / (kg · d) ] combined with low-dose Aspirin [15 mg/(kg · d] group (P＜0.05).2 mmol/L Aspirin did not inhibit the proliferation of MHCC97 cells (P＞0.05),but inhibited the activities and expressions of MMP-2 and VEGF.Low-dose IFN-α combined with low-dose Aspirin significantly decreased the expressions of MMP-2 and VEGF in nude mice (P＜0.05).ConclusionLow-dose Aspirin combined with low-dose IFN-α significantly inhibited the growth and metastasis of HCC through suppressing the expressions of MMP-2 and VEGF.

Objective To explore the association between the infection of human cytomegalovirus(HCMV),herpes simplex virus typeⅠ(HSV-Ⅰ),HSV-Ⅱ,toxoplasma(TOX) and serum hepatitis B virus(HBV)these 5 pathogens and low body weight and pneumonia,and explore the clinical value of nested polymerase chain reaction (PCR) examining newborns infected with pathogens.Methods Forty-six newborn infants with low weight and 66 newborn infants with pneumonia were selected.And 1 mL pripheral blood of every newborn infant was drawn.Classic phenol-chloroform-isoamyl alcohol-protease digested,after neonatal serum extraction of DNA in peripheral blood through 2 pairs of pri-mers,the outer primer amplified larger DNA fragments and the inner primer amplified small fragments,in the amplified products.HCMV,HSV-Ⅰ,HSV-Ⅱ,TOX and HBV of the viral DNA in highly conservative district to design primer respectively and amplify its viral DNA,nested PCR was used to detect of these pathogens DNA in infants of low body weight and pneumonia,and to detect positive rate of infection.Screening for birth defects in infants in these virus infection.SPSS 10.0 software was used to analyze the relationship between infection of 5 pathogens.Results The infective rate of HCMV in 46 infants with low body quality was 91.3%,the infective rate of HSV-Ⅰwas 8.7%,the infective rate of HSV-Ⅱwas 15.2%,the infective rate of TOX was 8.7%,and the infective rate of HBV was 15.2%.Among 66 infants with pneumonia,the infective rate of HCMV was 83.3%,the infective rate of HSV-Ⅰwas 6.1%,the infective rate of HSV-Ⅱwas 16.7%,the infective rate of TOX was 6.1%,and the infective rate of HBV was 7.6%.The infective rate of HCMV was higher than that of other 4 pathogens,these infection rates were different statistically in these 5 kinds of pathogens(Pa=0).Conclusions Five kinds of pathogens both low pathosens screening is necessary newborns infants with low body weight and pneumonia,and for the early diagnosis and prevention of these pathogens.

ObjectiveTo analysis the epidemic tendency of the methicillin-resistant Staphylococcus aureus(MRSA).MethodsClinical data of patients from August 2004 to August 2005 were analyzed retrospectively.Results62 Staphylococcus aureus were isolated,and the MRSA isolated rate was 59%.The MRSA patients tended to complex infection.ConclusionThe infection caused by MRSA is serious.It is necessary to take effective measures to control the MRSA prevalence.