Objective To investigate the feasibility of the lower cervical spine (C3 -C7 ) laminar screw technique for fixing adult posterior cervical spine .Methods We chose 9 formalin fixed moist adult cervical specimens ,which consist of male 6 and female 3 of the age 38 to 63 years old .The average age is 51 .9 years old and the average height is 165 .6 cm .Then we measured the thickness and heightof C3 -C7 lamina ,the lamina length of L1 ,L2 ,and the lamina of axis and the sagittal plane angle .Results The thickness and height of C3 -C7 lamina ,and the lamina length of L1 and L2 of adult male is bigger than adult women .There was statistical sig-nificance between the thickness ,height ,lamina length difference of different genders lamina (P<0 .05) ,but no significant difference between the left and the right (P> 0 .05) .The average lamina thickness of C2 ,C3 ,C4 ,C5 ,C6 ,C7 were respectively 4 .70 ,3 .87 , 3 .30 ,3 .84 and 5 .16 mm .The lamina thickness which was more than 4 .00 mm accounted for 54 .4% .The lamina thickness of C3 , C4 ,C6 ,C7 which was more than 4 .00 mm accounted respectively for 77 .8% ,61 .1% ,33 .3% ,and 88 .9% .Conclusion Crossing laminar screws in cervical spine is feasible in anatomy .The operation can make under direct vision ,and can accurately estimate the screw path length and entry angle .Patients with anatomic abnormalities can be used as an alternative fixation technique or as fixed in the fixed mode fails .So the results can provide a reference for clinical application .

Agglutinins ; immunology ; Anemia, Hemolytic, Autoimmune ; Humans ; Immunoglobulin G ; Infant, Newborn

AIM:To compare the accuracy of conventional contact A-scan and IOL Master in measuring axial length and anterior chamber depth, and to evaluate the characteristics of these two different methods.METHODS:Totally 145 cases (189 eyes) who underwent phacoemulsification and intraocular lens implantation in our hospital from January 2015 to December 2016 were observed prospectively.They were divided into five groups according to ocular axial length measured by IOL Master(Group A:AL≤22mm, Group B:22mm28mm).The axial length and anterior chamber depth were measured by A-scan and IOL Master respectively before operation, corneal curvature was measured by IOL Master.AL≤22mm using Hoffer Q formula to calculate the crystal degree, AL>22mm using Haigis formula to calculate the crystal degree.Analysis of axial length, anterior chamber depth and mean absolute refractive error at 3mo after surgery.RESULTS:The axial length measured by A-scan and IOL-master:Group A were 21.48±0.41mm and 21.46±0.40mm (P>0.05);Group B were 23.13±0.62mm and 23.14±0.63mm(P>0.05);Group C were 25.24±0.56mm and 25.27±0.59mm(P>0.05);Group D were 26.97±0.59mm and 27.03±0.64mm(P>0.05);Group E were 30.76±1.40mm and 31.01±1.53mm(P<0.05).Mean absolute refractive error (MAE) at 3mo after surgery by A-scan and IOL Master:Group A were 0.50±0.30D and 0.43±0.27D(P>0.05);Group B were 0.48±0.34D and 0.45±0.32D(P>0.05);Group C were 0.56±0.32D and 0.49±0.40D(P>0.05);Group D were 0.64±0.16D and 0.50±0.22D(P>0.05);Group E were 0.91±0.47D and 0.62±0.29D(P<0.05), MAE≤±0.50D were 38.7% and 65%(P<0.05), MAE≤±1.00D were 69.2% and 83.3%(P>0.05).Anterior chamber depth measured by A-scan and IOL Master:Group A were 2.81±0.35mm and 2.82±0.41mm (P>0.05);Group B were 3.04±0.50mm and3.10±0.47mm (P>0.05);Group C were 3.55±0.62mm and 3.60±0.52mm (P>0.05);Group D were 3.42±0.24mm and 3.51±0.30mm(P>0.05);Group E were 3.50±0.28mm and 3.61±0.34mm(P>0.05).CONCLUSION:IOL Master and contact A-scan have a high degree of consistency in the biological measurement, IOL Master has higher accuracy for patients with high myopia and long axis.It is a simple, accurate, good-repeatable and non-contact measurement tool.

Objective To analyze the clinical and immunological manifestations of antiphospholipid syndrome(APS)in a cohort of 100 patients.Methods The clinical and serologic features of APS(Sapporo preliminary criteria)in 100 patients were analyzed retrospectively.Results The cohort consisted of 79 female patients and 21 male patients witb a mean age of 36?13 years at diagnosis.Primary APS was presented in 37% of patients;APS was secondary to systemic lupus erythematosus(SLE)in 46%,lupus-like syndrome in 14%. Eighty percent of the patients had thrombosis,43(54%)patients had venous thrombosis,18(22%)had arterial thrombosis,15(19%)had both arterial and venous thrombosis.4(5%)had thrombosis of microcirculation. Forty-two(52%)patients presented thrombosis at a single site,26(32%)at two sites,12(15%)at three or more sites.Forty-five(56%)patients experienced one thrombotic episode,20(25%)patients had only one re- currence,and 15(19%)had more thrombosis.The most common manifestations of thrombosis were deep vein thrombosis(36%),pulmonary embolism(30%)and stroke(26%),with heart,kidney,gastrointestinal tract and other organs involvements.Thirty-four(51%)female patients had spontaneous fetal losses including intrauter- ine fetus death and recurrent spontaneous abortion.Seventy-one(71%)patients developed thromboeytopenia. The presence of antieardiolipin antibody(ACL)was detected in 84 patients(84%).Among 90 patients with APS,alone ACL was detected in 38 patients(42%),both ACL and lupus anticoagulant(LA)were detected in 36(40%),LA alone in 16(18%).Patients with APS associated with SLE or lupus-like syndrome had higher frequency of arthritis,leukopenia,antinuclear antibodies(ANA)and low complement levels.Female patients had a higher frequency of leukopenia,ANA and ACL.Male patients had a higher prevalence of deep venous thrombosis in the lower limbs and LA.Conclusion APS is an autoimmune disorder characterized by recurrent arterial and venous thrombosis,fetal loss,or thrombocytopenia with the presence of ACL and/or LA.In APS secondary to with SLE,the patient's sex can modify the disease expression and define specific subsets of APS.

Objective To investigate the feasibility, safety and short-term efficacy of endoscopic implantation of 5-FU Slow-release Particles for advanced gastroenteric tumor. Methods During the endoscopy procedure,slow-releasing 5-FU agents were implanted densely into the tumors and infiltrated area. Forty-five to sixty pieces of agents ( each piece equivalent to 1.67 mg 5-FU)were injected, which containing an average dose of 100 mg 5-FU. Results A total of 13 advanced gastric cancer patients were enrolled into this study. Significant effects were observed in 3 patients and good effects in 8 patients, but 2 cases with no effects. The total effective rate was 84.62%. The endoscopy examination showed that the size of tumors reduced in various degree at 1 - 2months after the implantation. No hemorrhage or perforation was observed. Parameters of hepatorenal function and routine blood test were stable after implantation. Conclusion Endoscopic implantation of 5-FU Slow-release Particles can relieve the symptoms of patients and limit tumor growth in advanced gastroenteric tumor with no marrow and hepatorenal functional impair.

Abstract:Alcoholic liver disease (ALD) is one of the most common liver diseases in the world. Long-term alcoholism causes a series of pathological changes in the liver, which eventually leads to the occurrence of liver diseases with an increasing incidence. At present, significant progress has been made in the pathogenesis and pathological development of alcoholic liver disease, but the relevant mechanism of ALD has not been thoroughly studied. It is necessary to improve the existing animal model or establish a new, more comprehensive animal ALD model to simulate human ALD. Experimental animal models of ALD, especially rodents, are often used to simulate human ALD, and the ideal rodent ALD model can effectively simulate all aspects of alcohol in human liver. But so far, the commonly used animal models all have certain defects, and there is no complete animal model that can simulate human ALD. This paper reviewed the pathogenesis of ALD, related methods and influencing factors of ALD model, and provided a theoretical basis for relevant researchers to establish the ALD rodent model. 

Objective To investigate the therapeutic effects of early enteral nutrition by gastroscopeguided naso-jejunal feeding tube placement on the intestinal endotoxemia of patient with severe acute pancreatitis (SAP).Methods Fourty-three patients were randomized into two groups:patients receiving early enteral nutrition (EN) by gastroscope-guided naso-jejunal feeding tube placement (24 cases) and those receiving total parenteral nutrition (TPN) ( 19 cases).The serum endotoxin(ET),albumin (ALB) and amylase (AMY) levels were measured.Abdominal distension and other complications were observed in the two groups.Results The abdominal pain and distension relief time,intestinal bleeding,infectious complications of EN group were significantly improved compared with that of TPN group ( P ＜ 0.01 或 P ＜ 0.05 或 P ＜ 0.001 ).The serum ET levels of EN group was much lower ( [ 0.19 ± 0.11 ] EU/ml) than that of TPN group ( [ 0.85 ± 0.28 ] EU/ml)on day 14 post-treatment (t =10.456,P ＜ 0.001 ).The serum AMY levels were decreased significantly in two groups after treatment,and the difference between two groups was not significant (t =3.l17,t =1.889,P ＞0.05 ).The serum ALB recovery of two groups was not significantly different ( P ＞ 0.05 ).Conclusion Gastroscope-guided Naso-jejunal feeding tube placement for early enteral nutrition can protect intestinal mucosa,reduce complications,alleviate symptoms of patients with SAP,which are benefitial factors for the treatment of intestinal endotoxemia in patients with SAP.

Objective To investigate the relationship between apoptosis of bone marrow cells and tumor necrosis factor-?(TNF-?),Fas/FasL expression in children with aplastic anemia.Methods The concentration of TNF-? in supernatant of cultured bone marrow mononuclear cell(BMMC) was measured by enzyme linked immunosorbent assay.The expression of Fas/FasL,apoptosis ratio of bone marrow CD34+ cell were evaluated by flow cytometry.Results The concentration of TNF-? in supernatant of cultured BMMC in AA group[SAA (27.9?8.20) ng/L;CAA (23.6?6.78) ng/L] increased significantly compared with control group(t=3.432 P0.05).Apoptosis ratio of CD34+ cell in SAA group[(24.6?9.56)%] and CAA group[(20.9?7.32)%] significantly increased compared with control group(t=3.492,3.458 Pa0.05).The concentration of TNF-? was positively correlated with the expression of CD34+ Fas+ in all types AA children(r=0.542 P0.05).Conclusions TNF-? and Fas/FasL system can be involved in inducing CD34+ cell apoptosis.This may contribute to understanding the decreased number of stem cells and bone marrow failure.

Objective To observe the distribution of bone marrow mesenchymal stem cells(MSCs) and the effects on expression of apoptosis relative proteins Caspase 3 and Bcl-2 after intravenous transplanted into ischemic rat brains.Methods MSCs from SD rats were cultivated and proliferated in vitro and marked with CFSE.MSCs were then intravenously transplanted into middle cerebral artery occlusion(MCAO)models of SD rats.The rats were killed at different time points to observe the distribution of MSCs under fluorescence microscoDe as well as the effects on expression of apoptosis relative proteins Caspase 3 and Bcl-2 using immunohistochemical method.Results Density of Caspase 3 in immunohistochemically positive area in transplantion group were(2.81±0.35)%,(3.98±0.67)%,(5.58±0.92)%,(3.51±0.63)%,(1.64±0.29)%in 6,12,24,72 hours and in 7 days,respectively,and decreased significantly compared with those of control group[(3.92±0.44)%,(5.23±0.30)%,(6.89±0.57)%,(4.39±0.57)%,(2.29±0.21)%],the difference being significant(t=4.37,3.34,2.60,2.32,3.90,P＜0.05 or＜0.01).The density of Bcl-2 in immunohistochemically positive area in transplantation group were(4.70±0.16)%,(5.61±0.26)%,(3.00±0.28)%respectively in 6,12 hours and in 7 days,which had improved significantly compared with those of control group[(3.28±0.27)%,(4.54±0.59)%,(2.15±0.62)%],the difference being significant(t=8.32,3.25,2.54,P＜0.05 or＜0.01).Conclusions Bone marrow MSCs can exert protective effects on brain ischemia and reperfusion injury possibly by down-regulating Caspase 3 and up-regulating Bcl-2.

Objective To evaluate the difference of internal diameter of bronchial artery in big lung cancer,small lung cancer,and normal lung with multiple slice CT.Methods MSCT angiographies of 44 patients with lung cancer confirmed by pathology were retrospectively analyzed,and 29 patients were with big lung cancer(≥3 cm)and 15 patients with small lung cancer(