Percutaneous vertebroplasty (PVP) is a relative new interventional technique, which is widely used in treatment of vertebral collapse caused by vertebral neoplasms and osteoporotic compression fractures. The general technical considerations of PVP techniques are discussed based on authors' experience obtained over 400 patients in the past years in this article, including preparation of PMMA, instrument of PVP, guidance and puncture approaches, and technique of the procedure, etc. The conclusion is that PVP is a safe procedure if the physicians handle it properly.

Objective To observe the characteristics of hemorheologic changes of hyperlipidemia rats at an early stage and to explore the mechanism of myocardial ischemic injury.Methods Seventy-two SD rats which were fed with high cholesterol diet(cholesterol+lard+pig bile salt) to result in hyperlipidemia model fell into HC group.Thirty-six SD rats which were fed with common diet fell into control group.The rats were fed for 10 to 90 d.At an interval of 10 d,9 time points were set.Therefore the 2 groups were randomly divided into 9 subgroups.At each time point,the changes of plasma lipids,cTnI,hemorheologic parameters,and pathological change of the rats’ myocardium and coronary vessel were assayed.Results The main characteristic of our models was hypercholesterolemia and high low-density-lipoproteins(LDL).With the extension of feeding time,plasma viscosity of HC group increased significantly,and erythrocyte deformability decreased.After fed with cholesterol for 50 d,myocardial ischemic injury occurred in the HC group.Correlation analysis revealed that the incidence of myocardial ischemic injury in hyperlipidemia rats was closely related with hypercholesterolemia and high low-density-lipoproteins.Conclusion The abnormal change of hemorheologic characteristics of hypercholesterolemia is a cause of myocardial ischemic injury.

Objective The effects of AM fungi on the growth of Bupleurum chinense were investigated by inoculation Glomus mosseae, G. caledonium, and the two fungal mixture under different phosphorus levels. Methods Pot culture and experimental analyses were carried out. Results Mycorrhizal infection rate could be promoted by inoculation and increased phosphorus content of plant and root dry weight; the content of chlorophyll, carotenoids, and soluble sugar of leaf was higher than that of controlled plant, and the soluble sugar content of plant root by inoculation the two fungal mixtures were lower than that of controlled plant. The inoculation effect of AM fungi was closed related to AM fungal species and phosphorus applied levels, which was the best under 0.1—0.3 g/kg P_2O_5 soil. Conclusion The growth of host plant and using rate of phosphorus fertilizer can be promoted by inoculation of AM fungi.

Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP) and endovascular chemotherapy and embolization for the treatment of vertebrae malignant tumors. Methods Twenty nine patients (male 16, female 13) had 40 vertebrae malignant tumors, including 28 patients with 37 vertebrae metastases and 1 patient with multiple myeloma involving 3 vertebrae. The primary foci were esophageal cancer, lung cancer, colon carcinoma, hepatic cancer, stomach cancer, breast cancer, kidney cancer and 2 of unknown. All the patients showed moderate or severe thoracic and lumbar pain with 2 patients of spinal cord dysfunction. Eighteen cases with 26 vertebrae were performed PVP only, 11 cases with 16 vertebrae were undergone endovascular chemotherapy and/or embolization. Results After treatment among 29 patients, 16 had CR(55.1%), 12 had PR(41.4%), 1 was unsuccessful with PVP but pain was relieved by endovascular therapy. No complication occurred.Conclusions PVP and PVP combined with endovascular therapy may have an excellent efficacy for vertebral malignant tumors, with relief of pain obviously and prolong the patient's life.

Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18?5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.

Objective To investigate the relativity of the lupus anticoagulant(LAC), anticadiolipin antibody(aCL) - IgG,aCL-IgM,aCL-IgA levels and clinical symptoms of systemic lupus erythematosus (SLE), and to determine the significance of the LAC level in the prognosis of idiopathic thrombocytopenic purpura (ITP) by detecting the LAC and aCL-IgG, IgM,IgA levels in 310 children with SLE and 249 children with ITP. Methods Kadin-cephalin clotting time(KCCT) and correcting test to detect the plasma LAC level and to the serum aCL- IgG, IgM, IgA levels with enzyme - linked immunosorbent assay. Results In SLE group, there were 66.1% patients with higher LAC among whom 45.9% patients suffered from lupus nephritis , aCL subantibody level elevated in 46.8% patients (90.2% IgG and/or IgM) serum; 46.9% and 11.7% patients suffered from central nervous system diseases and blood diseases with SLE respectively. In ITP group, 36.2% patients with LAC positive were diagnosed as SLE by detecting the serum antinuclear antibody level, and 7.6% suffered from SLE subsequently in the period of 2 months to 2.4 years. Conclusions The LAC and aCL subantibody levels may have an important relativity with the clinical symptoms of SLE. The LAC is the predominant pathologic autoantibody in patients with lupus nephritis, and the aCL subantibody( IgM, IgG) levels were related to lupus thromboangiitis. The IAC level of children with ITP should be monitored in order to determine the prognosis of the disease as soon as possible.

Objective To study the impact and mechanism of continuous venovenous hemofiltration (CVVH) in different uhrafihration rates on plasma cytokines in porcine endotoxemic shock. Methods Eighteen anesthetized mechanically ventilated pigs weighing 21-34 kg were randomly divided into three groups. In control group (n=6), the pigs received a 15.7 μg/kg endotoxin (E.coli 0111:84) infusion. In CVVH group (n=6) and high volume hemofihration (HVHF) group (n=6), the pigs received CVVH after the endotoxin infusion for 24 hours with an was taken before endotoxin infusion and at 0, 1, 6, 12, 24 h during CVVH. The plasma levels of TNF-α, IL-6, IL-10 and IL-18 were tested by ELISA. Results The survival time in control group was (15.4±5.2) h,CVVH group was (21.4±7.1) h,HVHF group was (22.4±6.7) h. The survival time in CVVH and HVHF group was significantly longer than that of control group (P< 0.05 ). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and cardiac output (CO) showed no significant differences among three groups. Plasma BUN and Ser increased gradually after the establishment of porcine endotoxemic shock model. BUN and Scr of CVVH and HVHF group were lower compared to control group (P<0.05), but there was no significant difference between CVVH and HVHF group (P>0.05). Plasma TNF-α and IL-6 peaked at T1, IL-10 peaked at TO, then they declined gradually. While IL-18 increased at TO and did not change after TO. A significant decrease of plasma IL-10 level was observed at T6, T12 and T24 in CVVH group compared with control group (P<0.05). HVHF group accomplished a greater decrease in plasma TNF-α (T6) and IL-10 (T6, T12, T24) levels compared with control group and CVVH group (P< 0.05). The levels of IL-6 and IL-18 showed no significant differences among three groups. There was a negative correlation between IL-6 and survival time (P<0.05). Conclusions HVHF and CVVH can prolong the survival time of porcine endotoxemic shock. IL-10 can be removed effectively with CVVH and HVHF. HVHF can also remove TNF-α effectively. CVVH and HVHF treatment can both remove BUN and Scr effectively. IL-6 is a powerful independent predictive factor for survival time of porcine endotoxemic shock.

Objective To evaluate the predictive value of Wells score combined with D-dimer in the diagnosis of acute pulmonary embolism.Methods A total of 540 patients with suspected pulmonary embolism admitted from 2008 to 2011 were enrolled for study.The diagnosis of pulmonary embolism (PE) was confirmed by using computed tomography pulmonary angiography (CTPA).These patients were divided into two groups:PE group and non-PE group.Comparative analysis was carried out in demographics,underlying diseases,chief complaints,physical signs,venous thrombosis risk factors,laboratory findings and Wells scores between the two groups.Results Of 502 patients selected into this study,there were 246 in PE group and 256 in Non-PE group.The incidence rates of history of recent surgery or bed-ridden,recent fracture of pelvis or lower limb,symptoms of hemoptysis,transient disturbance of consciousness,signs of unilateral lower limb swelling,hypoxia and hypocapnia of arterial blood gas analysis,elevated levels of D dimer,high Wells score in PE group were significantly higher than those in non-PE group (P ＜ 0.05).And there were no statistical difference in other variables found between the two groups.The areas under the ROC curve of Wells score,D-dimer and the combination of the two were 0.775 (95％ CI:0.719-0.831),0.802 (95 ％ CI:0.751-0.853) and 0.899 (95 ％ CI:0.834-0.964),respectively.And the area under the ROC curve of the combination of the two was greater than that of separated application (P ＜ 0.05).When the cut-off value of Wells score was 5 and D-dimer was 1 724 μg/L,the weighted maximum sensitivity and specificity were reached,and these cut-off values were higher than above determined values,the reliability of the diagnosis of PE was obviously increased,and those were lower than these cut-off values,the reliability of excluding PE was also increased.Conclusions Wells score combined with D-dimer showed a higher value in predicting acute pulmonary embolismthan than their separated application.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation (LDH) after the treatment of percutaneous lumbar discectomy (PLD), and to discuss the influential factors related to the long-term effectiveness. Methods During the period of January 2000 to March 2002, PLD was performed in 129 patients with LDH. By using self-evaluation questionnaires of Oswestry disability index (ODI), Short Form-36 (SF-36) and Japanese Orthopaedic Association (JOA) through letter or telephone interviews as well as the patients' initial medical records, the related clinical data were collected. Statistical analysis was conducted by using Wilcoxon's rank sum test, Chi-square test. Results One hundred and eight patients (83.7%) were able to be followed up and 104 effective ques-tionnaires were collected. The mean follow-up time was (6.64 ± 0.67) years, the excellent rate (ODI score, 0 ～ 20%) was 71.15%. The average scores of the JOA and SF-36 was 23.66 ± 5.72 and 75.88 ± 25.57, respectively. The scores of quality of life were obviously improved in all follow-up subscales. Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD. No complications related to PLD occurred in this study. The age, course of the disease and the patient's condition at the time of discharge might bear a relationship to long-term effectiveness. Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect, PLD can dramatically improve the quality of life. Many factors, such as the age, course of the disease and the patient's condition at the time of discharge, can affect the long-term outcomes.