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 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 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 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.

This article systematically introduced the development of Smart Healthcare mode in Hangzhou. From the aspects of connotation, pattern, characteristics and the change of medical treatment mode, the authors pointed out that the development of Smart Healthcare must follow such principles as satisfaction of the people, enhanced inter-departmental synergy, government-guided social participation, and full involvement of medical workers.

OBJECTIVE:To study the bioequivalence of Levodopa micro-capsule floating tablets in Beagle dogs after multi-dose administration. METHODS:6 dogs were collected and divided into Levodopa micro-capsule floating tablets group and Com-pound levodopa preparation group (Benserazide tablet,reference preparation). They were given levodopa 200 mg intragastrically, every 8 h,for consecutive 4 day. In two-period crossover test,HPLC method was established to determine the concentration of le-vodopa in dog. The pharmacokinetic parameter,bioequivalence and plasma concentration fluctuation of steady state were calculated. RESULTS:The main pharmacokinetic parameters of Levodopa micro-capsule floating tablets and reference preparation were as that cmax were(4.23±0.75)and(8.47±1.18)μg/ml;AUC0-∞ were(12.18±1.16)and(13.81±2.12)μg·h/ml;tmax were(1.83±0.26) and(0.67±0.13)h,respectively. 90% confidence intervals for the geometric mean ratio of AUC0-∞ for test and reference prepara-tion were 80.61%-97.90%,and that for cmax were 42.75%-57.63%,respectively. There was statistical significance in tmax between test and reference preparation. Degree of fluctuation of test and reference preparation at steady state were(283.914±43.217)% and (506.489±78.965)%,and fluctuation coefficient were(177.463±7.873)% and(187.405±1.650)%,respectively. The degree of fluctuation of test preparation was significantly less than that of reference preparation. CONCLUSIONS:Levodopa micro-capsule floating tablets show good sustained-release property,and are bioequivalent with reference preparation in absorption after multiple dose administration. It also has lesser fluctuation of blood concentration.

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 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 explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.