BACKGROUND:The patients with lumbar intervertebral disc protrusion can be treated with internal fixation of posterior surgery way. We can choose the conventional posterior intervertebral fusion nail stick system internal fixation. Isobar non-fusion internal fixation system was used in recent years. As a kind of a strong internal fixation of lumbar posterior dynamic screw rod fixation system, it has been gradual y applied in clinic, and has been one of patient’s treatment options. OBJECTIVE:To compare and analyze the clinical efficacy of Isobar non-fusion internal fixation system and traditional intervertebral fusion nail rod system internal fixation operation method in treatment of lumbar disc herniation. METHODS:From September 2011 to September 2012, 40 patients with lumbar disc herniation who were treated in the Department of Orthopedic, Changhai Hospital, the Second Military Medial University of Chinese PLA were enrol ed in this study. They were equal y assigned to the Isobar non-fusion internal fixation system group (Isobar group) and the traditional intervertebral fusion nail rod system internal fixation group (rigid internal fixation group) and subjected to corresponding treatments. RESULTS AND CONCLUSION:Surgery was successful y completed in patients of the two groups. These patients received at least 2 years of fol ow-up, no drop out. Compared with pre-fixation, low back pain Visual Analog Scale and Oswestry Disability Index were improved significantly after fixation in both groups. Compared with the rigid internal fixation group, range of motion of lumbar spine was larger in the Isobar group. Low back pain Visual Analog Scale and Oswestry Disability Index were similar between the two groups. These results indicated that posterior Isolbar non-fusion internal fixation obtained identical outcomes as traditional treatment, and showed more advantages in range of motion of lumbar spine.

Objective To evaluate the abilities and thresholds of stroke volume variation (SVV) and pleth variability index (PVI) in predicting fluid responsiveness during increased intra-abdominal pressure.Methods 28 patients undergoing laparoscopy-assisted radical gastrectomy were selected.PV1 was continuously displayed by the Masimo.Radical 7.All patients were also monitored with Vigileo/FloTrac system.Haemodynamic data such as MAP,HR,SVI,SVV,PI,PVI and C VP were recorded before and after volume expansion(HES 6％,7ml/kg).Fluid responsiveness was defined as an increase in SVI≥ 15％ (△ SVI ≥ 15).Results The SVV threshold of 9.5％ before volume expansion was able to diserimihate the responders from the non-responders with a sensitivity of 100％,and a specificity of 63.6％.The threshold for PVI was 14.0％,the sensitivity of 100％ and specificity of 81.8％ were obtained.There was no significant difference between the area under the receiver operating characteristics (ROC) curves of SVV and PVI(0.981,0.939,respectively),and there was significant correlation between the baseline SVV and the baseline PVI(r =0.740,P ＜ 0.01).Conclusion SVV and PVI can predict fluid responsiveness accurately during increased intra-abdominal pressure,the baseline SVV is correlated well with baseline PVI,and the ability of SVV and PVI in predicting fluid responsiveness is similar.

Allergens ; immunology ; Animals ; Asthma ; etiology ; Enzyme Activation ; Lung ; pathology ; Matrix Metalloproteinases ; physiology ; Mice ; Respiratory Syncytial Virus Infections ; enzymology ; pathology

Objective:To evaluate systematically the outcomes of prevention of fragility fracture with alendronate use for 3 to 4 years.Methods:We searched CENTRAL, MEDLINE, EMBASE and CBM for relevant randomized controlled trials published before 16 July, 2020. The quality of included studies was evaluated according to the Cochrane tool for assessing risk of bias. Fix- or random-effects were taken for meta-analysis depending on the magnitude of heterogeneity. Sensitivity analysis was used for high risk studies to assess the robustness of results. The results were reported according to The PRISMA 2009 Check-list.Results:A total of 8 reports from 4 studies were included. Two reports from 2 studies were rated as high-risk while the other 6 reports from the other 2 studies as low-risk. The meta-analyses showed that use of alendronic acid for 3 to 4 years effectively prevented new vertebral fracture ( RR=0.54, 95% CI: 0.44 to 0.66, RD=-0.03), clinical fracture ( RR=0.82, 95% CI: 0.73 to 0.92, RD=-0.03), non-vertebral fracture ( RR=0.84, 95% CI: 0.75 to 0.95, RD=-0.02), clinical vertebral fracture ( RR=0.51, 95% CI: 0.34 to 0.76, RD=-0.01) and hip fracture ( RR=0.56, 95% CI: 0.37 to 0.87, RD=-0.01), but did not prevent wrist fracture ( RR=0.85, 95% CI: 0.67 to 1.09), serious adverse event ( RR=0.95, 95% CI: 0.80 to 1.14) or upper gastrointestinal adverse event ( RR=1.02, 95% CI: 0.96 to 1.07). By the sensitivity analysis of the 6 results from the high-risk reports, the HRs for clinical fracture, non-vertebral fracture, vertebral fracture, hip fracture, wrist fracture, and serious adverse event were, respectively, 0.81, 0.85, 0.49, 0.62, 0.94 and 0.94. Conclusions:Alendronate use for 3 to 4 years can effectively prevent fragility fractures in postmenopausal women with low bone mass or osteoporosis, leading to better prevention effect on vertebral fracture than on non-vertebral fracture.

Objective To evaluate the clinical effect of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for refractory ulcerative colitis (UC).Methods In this study 60 refractory UC patients received IPAA operation during the period of 1990 to 2010.Data were collected regarding early and late postoperation complications,anal continence function,and characteristics of feces.The patients' quality of life was objectively accessed using the Clevend Global Quality of Life (CGQL)index.0ne-way analysis of variance was used.Results Mean follow-up period was 2 years.Early postoperative complication rate developed in 15％ (9/60),including abdominal or pelvic infection,anastomotic leak,pouch bleeding,pouch-vaginal fistula,and intestinal obstruction.Late postoperative complication rate was 12％ (7/60),including pouchitis,intestinal obstruction,and male sexual dysfunction.Stool frequency per 24 hours and that at night was 3.5 ± 1.3 and 1.4 ±0.6.93％ (56/60)patients differentiated gas and feces well and 3％ (2/60) needed daily pads.According to Kirwan Grading Scale,anal function outcomes were Grade Ⅰ:54 (90％),Grade Ⅱ:4 (7％),and Grade Ⅲ:2 (3％).According to Bristol Stool Form Scale,characteristics of feces were Grade Ⅳ:31 (52％),Grade Ⅴ:25(42％),and Grade Ⅵ:4 (6％).Postoperative CGQL result showed a much better quality of life than preoperative CGQL (F =12.368,P ＜ 0.05).Conclusions Refractory UC is surgically indicated and IPAA is the operation of choice with safety,satisfactory long-term outcome and improved quality of life.

A certain amount of image noise is increased in low-dese protocols, but image quality is still acceptable without problem in CT localization. The reduction of radiation dose and the radiation harm to patients are the superiority.

OBJECTIVETo investigate the therapeutic effect of retroviral endostatin gene transfer on the human colon cancer cell line, LoVo.

METHODSA retroviral vector pLESSN expressing secretable endostatin was constructed and packaged with a titer of 8.2 x 10(5) CFU/ml. A LoVo cell line was subjected to retrovirus-mediated endostatin gene transfer. The proviral integration of endostatin was analyzed with PCR. The function of endostatin was tested by MTT assay in vitro and a mouse xenograft model in vivo.

RESULTSAfter transfection and superinfection, amphotropic retrovirus was collected, and transduction with amphotropic retroviruses resulted in endostatin proviral integration. The endostatin secreted by transduced LoVo cells markedly inhibited cell growth up to 67% (P<0.001), compared with the control cells. The gene expression of endostatin in LoVo colon tumor cells significantly inhibited tumor growth in vivo. There was an 86% reduction in tumor size in the endostatin-transduced group, accompanied by a reduction in vessels, compared with the control group (P<0.01).

CONCLUSIONRetroviruses can allow functional expression of the endostatin gene in human colon tumors, showing promise for an antitumor strategy using antiangiogenesis.

Cell Division ; Cell Line, Tumor ; Colonic Neoplasms ; pathology ; therapy ; Endostatins ; genetics ; Gene Transfer Techniques ; Genetic Vectors ; Humans ; Retroviridae

OBJECTIVETo observe the effect of Yishen Zhongzi Pill (YZP) on the sperm motility of Shen-essence deficiency syndrome (SEDS) patients.

METHODSTotally 144 patients were randomly assigned to the treatment group (71 cases) and the control group (73 cases). Ten cases dropped out during the therapeutic course. A total of 134 patients completed this clinical study, 67 in each group. Patients in the treatment group took YZP (6 g each time, twice daily), while those in the control group took Wuzi Yanzong Pill (6 g each time, twice daily). The therapeutic course for all was one month. Changes of the sperm motility, clinical efficacy, and Chinese medical symptoms scores were observed between the two groups before and after treatment.

RESULTSCompared with before treatment in the same group, percentages of class a spermatozoa and class a + b spermatozoa were enhanced in the two groups after treatment (P <0. 01). Besides, they were higher in treatment group than in the control group (P <0. 05). The total effective rate of the treatment group was 77. 61 % (52/67 cases), while it was 58. 21 % (39/67 cases) in the control group. It was better in the treatment group than in the control group (Z= -2. 914, P =0. 004). Compared with before treatment in the same group, scores for Chinese medical symptoms decreased in the two groups (P <0. 01). The difference of pre-post integrals was higher in the treatment group than in the control group (P <0. 01).

CONCLUSIONYZP showed favorable effect in treating asthenospermia patients with SEDS and could effectively elevate the motility of sperm.

Asthenozoospermia ; therapy ; Biomedical Research ; Drugs, Chinese Herbal ; Humans ; Male ; Medicine, Chinese Traditional ; Oils, Volatile ; Phytotherapy ; Sperm Motility ; Spermatozoa ; Syndrome

Objective This study investigates feasibility of replacing urinary epidermal cells with foreskin epidermal cells to reconstruct engineered anterior urethra with acellular collagen matrix. Methods A cellular collagen matrices were generated from allogeneic rabbit bladder submucosa.In 6 rabbits,autologous foreskin epidermal cells isolated,in vitro expanded and labeled with Brdu before seeding onto a tubular collagen matrix of 2 cm long.In 12 male rabbits, urethral mucous defect was created and urethroplasty was performed with tubular collagen matrix seeded with epidermal cells (n=6) in experimental group or matrix without cells seeding (n=6) in control group.Urethrography was performed at 1,2,and 6 months postoperatively.Urethras grafts were harvested and analyzed grossly and histologically at the same time points. Results In control group, gross and urethrography demonstrated urethral stricture of repaired defects at all time points.Histology showed a single layer of epidermal cell with unorganized and crassitude muscle fiber bundles in submucosa layer.In contrast, urethrography showed a patency of repaired urethral defect with the maintenance of a wide urethral caliber in experimental group without sign of strictures at any time points. Histologically,the graft seeded with epidermal cell had a multi-layers epidermal cells by 1 month,which demonstrated the presence of a epidermal cells layer with a normal submucosa structure.The immunoflorescent staining of Brdu confirmed the presence of implanted epidermal cells.In addition, the implanted cells also express keratin when stained with anti-pancytokeratins AE1/AE3 antibody.At 2 month,histology showed relatively normal urethral architecture with vessel abundance in submucosa structure.The staining of Brdu showed decreased at implanted epidermal cells and epithelial phenotypes were confirmed immunocytochemically using pancytokeratins AE1/AE3.At 6 month,the graft structure show multi-layers epidermal cells without staining of Brdu. Conclusions Urethra reconstruction was better achieved with cell seeded acellular collagen matrix when compare with acellular matrices alone.Foreskin epidermal cells seems succeeded in replacing urethral epidermal cells for urethra reconstruction.

Objective To evaluate the value of echocardiography in investigation the failure of interventional therapy of VSDs and to increase the successful rate. Methods 15 cases with failure of VSD closure through interventional approach were undertaken measurement of major parameters of the defect on left ventriculography and then followed by Philips 5500 color Doppler US for repeated multi-direction tangential measuring of the size, morphologic change, relation with peripheral structure and individual valvular regurgitation. Results (1) Marginal membranous VSD 10 cases; membranance aneurysm 8 cases, ≥2 outlets 6 cases. Width of basal part of membranous aneurysm was 8 ～ 18 (10 ?2) mm with depth of 3 ～ 10 (6 ? 2) mm, distance from aortic valve was 0 ～ 6 (2 ? 1) mm and from tricuspid valve was 2 ～ 5 (2 ?1) mm; associated with slight tricuspid valvular regurgitation. Aortic valvular regurgitation 5 cases showed slight to mild amount and without membranous aneurysm occurred in 2 cases. (2) Intracristal VSD 5 cases showed the size of defect as 6 ～ 10 (7 ? 1) mm, with distances of 2 ～ 3 (1 ? 0.8) mm from pulmonary valve and 1 ～ 2 (1 ? 0.6) mm from aortic valve associated with slight regurgitation in 4 cases, slight tricuspid valvular regurgitation in 5 cases and aortic valvular prolapse in 4 cases. Conclusions Many factors can influence the direction tangential continuous scanning should be taken for accurate localization and measurement of VSD in order to select the very sight occludor providing high successful rate of occlusion and long term efficacy.