BACKGROUND:Posterior lumbar interbody fusion is a typical therapeutic method of lumbar degenerative disease. Present studies suggested that adjacent segment degeneration occurs after fusion. Recently, more and more scholars paid attention to the development of non-fusion of the spine. ＜br> OBJECTIVE:To compare clinical effects of Dynesys dynamic stabilization system fixation and posterior lumbar interbody fusion in treatment of lumbar degenerative disease. ＜br> METHODS:From July 2009 to July 2011, clinical data of 56 patients with lumbar degenerative disease were retrospectively analyzed. There were 28 cases of Dynesys dynamic stabilization system fixation, and 28 cases of posterior lumbar interbody fusion. Operation time, bleeding volume, and postoperative hospitalization time were compared in both groups. Visual analog scale was used to assess pain. Oswestry disability index was utilized to evaluate clinical effects. ＜br> RESULTS AND CONCLUSION:A total of 56 patients were fol owed up for 18-24 months. Visual analog scale and Oswestry disability index scores were significantly improved at 12 months after treatment in both groups (P＜0.01). Significant differences in operation time, bleeding volume, and postoperative hospitalization time were detected between both groups (P＜0.01). Dynesys dynamic stabilization system group was better than posterior lumbar interbody fusion group. Range of motion was better in the Dynesys dynamic stabilization system group than in the posterior lumbar interbody fusion group (P＜0.01). During fol ow-up, nail rope system and polyester sleeve loose were not detectable in the Dynesys dynamic stabilization system group. These results verified that compared with posterior lumbar interbody fusion, Dynesys dynamic stabilization system for lumbar degenerative diseases has a high safety and smal trauma, and can keep advantages of a fixed segment, and exert a certain effect on degeneration of intervertebral disc in the adjacent segment.

Objective To explore the features of transsphenoidal microsurgical treatment of male pro- lactinoma and to evaluate the sexual function before and after transsphenoidal microsurgery.Methods A se- ries of 23 cases male prolactinoma were analysed combined with retrospective and prospective study.9 casese with sexual disfunction had finished the International Index of Erectile Function with 15-item questionnnaire (ⅡEF-15) before and after the surgery.Results 8/10 cases treated with dopaminergic agonist combined with surgery achieved complete remission,while only 4/13 cases achieved complete remission with surgery on- ly(x~2=5.490,P=0.036).Aecoding toⅡEF-15,sexual function improved after surgery in 9 cases(paired- sample) t test,P＜0.05).Conclusion Transsphenoidal microsurgical treatment of prolactinoma may im- prove the male sexual functions.Dopaminergic agonist combined transsphenoidal microsurgery may achieve a better outcome.

Objective To evaluate the dose distribution in clinical target volume (CTV) and organs-at-risk (OARs) in three dimension therapy plans in patients with squamous cell carcinoma of tongue receiving postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT) by dosimetric study. Methods Thirty-five patients with squamous cell carcinoma of tongue were divided into CRT group(n=17) and IMRT group(n=18). All patients underwent head-and-neck immobilization with a thermoplastic mask and planning CT scan, and target volume and OARs were contoured. Dose calculation and plan optimization were performed. All three dimension plans passed quality assurance before treatment. The dosimetry of therapy plans with IMRT or CRT in target volume and OARs dose distribution was compared by dose-volume histogram (DVH), conformity index (CI) and homogeneous index (HI). Results There were significant differences in D95 (isodose line to cover 95 percent target volume), CI, HI, minimum dose and maximum dose in CTV of therapy plans between patients with IMRT and CRT(P < 0.01), and there was no significant difference in mean dose of CTV(P > 0.05). The radiation dose on salivary glands (both parotid glands and contralateral submandibular gland) in patients with IMRT was significantly lower than that in patients with CRT(P < 0.01). Conclusion Compared with dose distribution of CRT plans, there are more advantages in improving dose distribution at the target volume and sparing salivary glands in IMRT therapy plans in patients with squamous cell carcinoma of tongue.

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

AIMIn order to evaluate the regulatory effects of nucleotides and adenosine on ATP-sensitive potassium channel (K(ATP)) in artery smooth muscles, the effects of them on vascular relaxation induced by K(ATP) opener pinacidil(Pin) were investigated.

METHODSThe isolated endothelium- denuded aorta rings were preincubated with nucleotides or nucleotides and glibenclamide (Gli) for 10 min, the vascular relaxation induced by Pin in aorta precontracted with 20 mmol x L(-1) KCl was observed.

RESULTSAfter the isolated endothelium-denuded aorta rings were preincubated with ATP, ADP, UDP, GTP and adenosine (Ade) 100 micromol x L(-1) respectively, the vascular relaxation induced by Pin was changed as following: (1) ATP could inhibit the K(ATP) activation by Pin and enhance the blockade of K(ATP) by Gli. (2) ADP could inhibit the K(ATP) activation by Pin and attenuate the blockade of K(ATP) by Gli. (3) The regulatory effect of Ade on K(ATP) was similar with that of ADP. (4) UDP could enhance the K(ATP) activation by Pin and attenuate the blockade of K(ATP) by Gli. (5) GTP could enhance the K(ATP) activation by Pin, but had no effects on the blockade of K(ATP) by Gli.

CONCLUSIONNucleotides and adenosine, related to energy metabolism, could modulate the functions of K(ATP) in vascular smooth muscle. But their pharmacological characteristics were different.

Animals ; Aorta ; cytology ; drug effects ; Glyburide ; pharmacology ; In Vitro Techniques ; KATP Channels ; metabolism ; Male ; Muscle, Smooth, Vascular ; drug effects ; Nucleotides ; pharmacology ; Pinacidil ; pharmacology ; Rats ; Rats, Wistar ; Vasodilator Agents ; pharmacology

In view of problems such as students in clinical orthopedic practice lack of basic theoretical knowledge and practical ability, both teachers and students' lack of preparations for clinical practice and their insufficient attention etc., this paper attempts to strengthen the standardized management of department teaching. Some measures were adopted to stimulate the potential of students, such as teaching based on case combination, department discussion, strengthening education of humanities, improving examination methods and so on, so as to improve students' comprehensive ability and achieve teaching goals. The results showed that by changing the above teaching methods, students can improve their mastery of knowledge, proficiency in basic operation, clinical thinking ability, communication and coordination ability, subjective initiative and so on. At the same time, students' problem-solving ability, learning interests, self-confidence and the satisfaction with teaching effect have also been improved, which promoted the performance of students in clinical practice.

OBJECTIVETo evaluate the efficacy of percutaneous laser and O2-O3 mixture in treating chronic discogenic low back pain.

METHODSThere were 48 patients included 32 male and 16 female with the mean age of 43.5 years (range, from 21 to 66 years). The duration of symptoms was more than 6 months, all patients were treated with percutaneous laser and O2-O3 mixture under TV monitoring.

RESULTSForty-eight patients followed-up showed no severe complications. At 1 week follow up, 8 cases were evaluated as excellent, 28 as good, 8 as fair and 4 as poor by Macnab standard. The excellent and good rate reached 75%. At 3 months follow up, 17 cases were evaluated as excellent, 23 as good, 6 as fair and 2 as poor with the excellent and good rate of 83.3%. At 6 months follow up, 20 cases were evaluated as excellent, 22 as good, 4 as fair and 2 as poor with a total effective rate of 87.5%. At 12 months follow up, 21 cases were evaluated as excellent, 22 as good, 4 as fair and 1 as poor with a total effective rate of 89.6%.

CONCLUSIONCombined percutaneous laser and O3-O3 mixture is an effective and safe method in treating discogenic low back pain.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Low Back Pain ; radiotherapy ; Male ; Middle Aged ; Ozone ; therapeutic use ; Treatment Outcome

OBJECTIVETo clone PIB gene of Neisseria gonorrhoeae, and to construct a recombinant eukaryotic expression vector pCI-PIB and to understand the effects of pCI-PIB vaccination in mice to induce specific humoral and cellular immune responses.

METHODSThe entire PIB gene of Neisseria gonorrhoeae (960 bp) was amplified by using PCR. An eukaryotic eukaryotic vector pCI-PIB was then constructed. BALB/c mice (n = 65, 100 microg/time/mouse) were immunized with pCI-PIB by intramuscular injection. ABC assay was employed to examine the PIB expression in muscular cells of the pCI-PIB-immunized mice (n = 10). ELISA and MTT assays were used to measure the effects of humoral and cellular immune responses of the remaining pCI-PIB-immunized mice. By using slide agglutination test and complement bacteriolytic test, the serum anti-bacterial activity of the pCI-PIB immunized mice was determined.

RESULTSThe entire PIB gene amplification fragment of the expected size (960 bp) was successfully obtained by PCR. In comparison with the reported PIB gene sequence (GenBank No: AF090801), the homology of nucleotide sequence of the target inserted fragment in the recombinant plasmid pCI-PIB was as high as 99.28%. The muscular cells of the immunized mice could take in pCI-PIB and then express PIB. In the pCI-PIB immunized mice, the higher titer (1:4000) of specific serum IgG and the specific T lymphocyte response were found. The proliferation index (4.031) was significantly higher than that of the controls (1.127) (t = 71.71, P < 0.05). The sera and washings from the pCI-PIB immunized mice could agglutinate Neisseria gonorrhoeae and kill this microbe in presence of complements.

CONCLUSIONIn this study we successfully constructed a recombinant eukaryotic expression vector pCI-PIB. The mice inoculated with pCI-PIB might efficiently produce the specific humoral and cellular immune responses, suggesting that pCI-PIB should be potential service as a candidate of Neisseria gonorrhoeae DNA vaccines.

Animals ; Antibody Formation ; Bacterial Outer Membrane Proteins ; genetics ; immunology ; DNA, Recombinant ; immunology ; Female ; Immunity, Cellular ; Mice ; Mice, Inbred BALB C ; Neisseria gonorrhoeae ; genetics ; immunology ; Plasmids ; Vaccines, DNA ; immunology

OBJECTIVETo explore the effects of adrenomedullin (ADM) on Angiotensin II (AngII)-induced collagen synthesis in cultured rat vascular adventitial fibroblasts.

METHODSRat vascular adventitial fibroblasts were cultured in vitro. ADM produced and secreted from adventitia in the presence of AngII was detected by radioimmunoassay, type I, III collagen contents in adventitia fibroblasts were measured by ELISA and the expressions of TGFbeta1 and MMP-2 were determined by RT-PCR and Western blotting.

RESULTSAngII significantly induced ADM secretion in adventitial fibroblasts in a dose-dependent manner. These effects could be reduced by 45%, 3% and 46%, through pre-treatment with Losartan, PD123319 or both, respectively for 30 min in culture medium. The AngII-induced type I, III collagen secretion in adventitial fibroblasts was significantly reduced by AMD in a dose-dependent manner, (P < 0.01) while ADM agonist ADM(22 - 52) significantly potentiated the effect of AngII; ADM also reduced AngII-induced expression of TGFbeta1 at mRNA and protein levels in a dose-dependent manner. AngII reduced the expression of MMP-2 at mRNA and protein levels in adventitial fibroblasts and these effects could be reversed by AMD (10(-8) mol/L).

CONCLUSIONAngII stimulated ADM secretion in adventitia fibroblasts, ADM in turn can inhibit AngII-induced type I, III collagen synthesis in adventitial fibroblasts probably by downregulating the TGFbeta1 expression and upregulating MMP-2 expression. ADM therefore served as an antifibrotic factor in vascular remodeling process.

Adrenomedullin ; metabolism ; Angiotensin II ; metabolism ; Animals ; Cells, Cultured ; Collagen Type I ; biosynthesis ; Extracellular Matrix ; metabolism ; Fibroblasts ; metabolism ; Gene Expression Regulation ; Male ; Matrix Metalloproteinase 2 ; metabolism ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo explore the apoptosis resistance induced by Leptin and its mechanism in breast cancer cells in vitro.

METHODSThe leptin-mediated reduction of docetaxel-induced apoptosis in human breast cancer T47D cells was evaluated by TransAM ELISA, MTT and caspase-9 assay. The leptin-promoted survivin expression was analyzed by Western-blot and RT-PCR. The reversing effect of STAT3 knockdown on leptin-induced survivin upregulation was measured by Western-blot and RT-PCR.

RESULTSLeptin promoted T47D cells proliferation and the inhibitory rate was -63.6%. It reduced docetaxel-induced apoptosis in T47D cells by 31.9%. Leptin at different concentrations promoted survivin protein and mRNA expression in T47D cells. The expression of survivin mRNA was 4.6 fold compared with the T47D cells not treated with leptin(10 nmol/L). The expression of survivin mRNA in T47D cells was 0.55 +/- 0.15 fold after transfected with small interfering RNA (siRNA) of STAT3. The expression of survivin mRNA in STAT3 siRNA group and mock transfected group were 0.56 +/- 0.18 fold and 1.61 +/- 0.22 fold after treated by leptin, respectively. The survivin protein level of T47D mock transfected cells was increased after treated by leptin, but the protein level of T47D transfected with STAT3 siRNA cells were not changed significantly.

CONCLUSIONLeptin/STAT3 signaling is a novel pathway for up-regulation of survivin expression in breast cancer cells.

Apoptosis ; drug effects ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Leptin ; pharmacology ; Microtubule-Associated Proteins ; genetics ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; STAT3 Transcription Factor ; genetics ; metabolism ; Signal Transduction ; Transfection ; Up-Regulation