Objective To compare medium-term therapeutic effect by bilateral and unilateral puncture plasma coblation nucleoplasty(PCN) in the lumbar disc herniation patients. Methods 90 cases confirmed no significant rupture of annulus fibrosus of lumbar disc herniation by CT or MRI were randomly divided into two groups. Bilateral and unilateral puncture plasma coblation nucleoplasty groups were respectively divided into group A and group B, and compared the JOA scores. Results 82 patients were followed up for 10 ～ 32 months,the average follow-up time was 16.2 months. Preoperative JOA scores of the two groups were not statistically significant(P ＞ 0.05) but the postoperative follow-up JOA scores were higher than preoperative(P ＜0.05) and the JOA scores of group A were higher than group B(P ＜0.05). Conclusion The medium-term therapeutic efficacy of bilateral puncture coblation nucleoplasty was superior to unilateral therpy.

Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

ObjectiveTo investigate the efficacy and toxicity of docetaxel combined with compound tegafur capsule(S-1)on anthracycline-refractory recurrent metastatic breast cancer (ARMBC).Methods Thirty-eight ARMBC patients were given intravenous 70 mg/m2 docetaxel at day 1,and oral 60 mg/m2 S-1twice every day at day 1 to 14.Every 3 weeks was one cycle and each patient received at least two cycles.ResultsAfter treatment,among these 38 patients,there was 2 complete response (CR) (5.3 ％),20 partial response (PR) (52.6 ％),10 stable disease (SD) (26.3 ％),and 6 progressive disease (PD) (15.8 ％).Overall objective response rate was 57.9 ％ (95 ％ confidence intervaal: 42.6 ％-74.2 ％) while clinical benefit response rate was 73.7 ％ (95％ confidence interval: 58.4 ％-89.1％).The median time to progression (TTP) was 7.8 months(95 ％ confidence interval:6.7-8.9 months),and median overall survival time(OS)was 15.7 months (95 ％ confidence interval: 12.9-18.8 months).The main toxic reaction was myelosuppression,and grade Ⅲ and Ⅳ adverse events including leucopenia occurred in 21.1％ of all cases.Most common grade Ⅰ and Ⅱ adverse events,such as hand-foot syndrome,nausea,vomiting,diarrhea,liver dysfunction,and oral mucositis,were tolerable.ConclusionGood clinical efficacy is achieved in the therapy of metastatic breast cancer with docetaxel and S-1 combination regimen and toxic reaction is tolerable.

Objective To explore the clinical therapeutic effects of postoperative intracranial infection in neurosurgery.Methods Between January 2014 and January 2014,50 patients with postoperative intracranial infection in the department of neurosurgery in our hospital were selected in this study.Among the 50 patients,25 patients were treated by intravenous antibiotic therapy,15 patients were treated with intrathecal and intravenous antibiotics treatment,10 cases were treated by intrathecal injection,intravenous antibiotics and lumbar pool catheter drainage way for treatment,and then we observed the clinical therapeutic effect of three groups of patients.Results In 50 patients,37 patients were cured,3 cases had marked effect,8 patients had effect,2 patients had no effect.Conclusion For patients with neurosurgical operations,to maximally reduce the risk of intracranial infection,it is necessary to take antibiotics according to the actual situation of patients,and make different treatment schemes according to the difference of infection.

Objective To investigate the change of intestine mucosal permeability during cardiopulmonary bypass (CPB) and its effect on gut barrier in rats model. Methods The rats model of CPB was established and samples of tissue and plasma were collected at different intervals. Plasma D-lactate and LPS concentrations were determined and gut tissue was examined microscopically. Results The plasma concentration of D-lactate and LPS increased gradually at 1h CPB, and increased markedly 1h after CPB. They recovered to normal 8h after CPB, respectively. In addition, it was noted that there was a significant positive correlation between the plasma concentrations of LPS and D-lactate (r = 0.8312, P

Objective To investigate the role of cell apoptosis in the gut mucosal barrier dysfunction in rats undergoing cardiopulmonary bypass(CPB) . Methods The rat model of CPB was set up. The rats were divided into CPB group, sham operation(SO) group and normal control group. The morphological changes of ileum mucosal tissues were observed by microscope and electron microscope at 3h, 6h, 12h and 24h after operation, respectively. The apoptotic index of gut mucosal epithelial cells was measured with TUNEL method. Results Gut mucosal morphology was normal in CPB group at 3h, 6h and 12h after operation, but gut mucosal epithelial desquamation occurred at 24h after operation. Typical apoptotic cells could be seen with electron microscope in CPB group at every time point. Apoptotic index of gut mucosal epithelial cells significantly increased in CPB group at every time point compared with SO group, and peaked at 6h after operation. Apoptotic cells were mostly located in the gut crypt. Conclusion The data suggested that the apoptosis of intestinal epithelial cells significantly increased at early stage of post-CPB in rats, which might contribute to gut mucosal barrier dysfunction.

Objective To study cervical HPV infection in female patients with vulvar condyloma acuminatum(CA)from Shanghai area.MethodsExfoliated cells were obtained from cervices and vulva lesions of CA of 194 patients.respectively.HPV genotyping was carried out in cell samples using capture-hybridization method and gene chip techniques.Results HPV was detected in vulva lesions of all the 194 patients.Among them,74.2%(144/194)were positive for low risk(LR)-HPV,and 25.8%(50/194)for high risk(HR)-HPV.A single HPV genotype(6 or 11)was detected in 136(94.4%)patients with LR-HPV.and mixed genotypes of LR-HPV and HR-HPV in 46(86%)patients with HR.HPV.Of the 194 patients.85.6%(166/194)were complicated by cervical HPV infection.including 119(61.4%)cases of LR-HPV and 46(23.7%)cases of HR-HPV,In the case of HPV genotype.the consistence between CA lesions and cervix was 95.8%(159/166).The prevalence of LR-HPV declined sequentially from subtype 11 to 6 and 53,and that of HR-HPV from subtype 16 to 18 followed by 52,31,45 and 58.Conclusions There is a high rate of infection with HR-HPV in female patients with CA.and nearly one quarter of these patients are complicated by cervical HR-HPV infection.

Objective To investigate the causes and prevention of postpartum hemorrhage. Methods 84 cases with postpartum hemorrhage were analyzed. Results The main cause of postpartum hemorrhage was involved in poor contraction of uterus; The second cause was concerned with placenta; There was higher rate of postpartum hemorrhage after caesarean section than vaginal delivery. Conclusion It was necessary for preventing postpartum hemorrhage to strengthen antenatalcare, improve labor observe, decrease caesarean section.

BACKGROUND:Fragile bone in senile osteoporosis patients easily weakened pedicle screw fixation capacity. Therefore, bone cement leakage and screw removal cannot be solved during pedicle screw repair in osteoporotic patients with degenerative lumbar spine. OBJECTIVE:To investigate the biomechanical properties of novel pourable pedicle screws and bone cement application effect in osteoporotic patients with degenerative lumbar spine. METHODS:Six lumbar specimens (T11-L5) at the mean age of (72.9±4.2) years were selected, total y 42 vertebrae. The average bone density was 0.696 g/cm2. Any side of al vertebrae was inserted with pourable pedicle screws. 2 mL of bone cement was perfused under the X-ray fluoroscopy with cement push rod and fil ing cylinder. The same number of conventional screws was inserted into the opposite side of the samples. Three-point bending test was performed in two kinds of screws. The maximum vertebral axial pul out force test and the maximum spin torque test were conducted in vertebra to observe the destruction of the vertebral body and implanted effect. RESULTS AND CONCLUSION:(1) The ultimate strength and yield load of novel pourable cement pedicle screws were significantly more than conventional screws (P<0.05). Ultimate displacement and yield displacement were significantly less in novel pourable cement pedicle screws than in conventional screws (P<0.05). (2) The maximum vertebral axial pul out force and the maximum spin torque were significantly higher in novel pourable pedicle screws than in conventional screws (P<0.05). (3) In summary, novel pourable cement pedicle screw is simple to operate, can effectively control bone cement penetration, and improve screw stability in osteoporotic vertebrae. Moreover, after treatment, the removal of screws is convenient, cannot evidently destroy vertebral body or screw channel, and promote early recovery.

Objective To explore the protective effects of pretreatment with alanyl-glutamine dipeptide on intestinal barrier function in rats after cardiopulmonary bypass.Methods CPB model in rats was established.60 SD rats were randomly divided into group G(pretreatment with alanyl-glutamine before CPB for 3 days and primed with it during CPB,n =20),group CPB(n =20) and sham-operation(SH) group(n =20).The diamine oxidase(DAO) activity of plasma and tissue homogenate of intestinal mucosa were measured by spectrophotometry,and the concentration of plasma D-lactate was also detected by spectrophotometry.The levels of plasma lipopolysaccharide(LPS) was measured by tachypleus amebocyte lysate development process.And software SPSS 16.0 was used for statistics analysis.Results The plasma DAO activity in group G was significantly lower than that in group CPB(P ＜0.05),even though compared with group SH,the DAO activity in group G and CPB were significantly increased (P ＜ 0.05).The activity of DAO in tissue homogenate in group G and CPB were decreased more significantly than that in group SH(P ＜ 0.05),but there was no difference between group G and CPB (P =0.065).The plasma concentrations of D-lactate and LPS in group G were significantly lower than that in group CPB (P ＜ 0.05),and the plasma concentration of D-lactate and LPS in both group G and CPB were markedly enhanced compared with group SH(P ＜ 0.05).Conclusion Precondition with alanyl-gluamine dipeptide can decrease the permeability of gut mucosa,and might be a new way to protect the intestinal barrier function during cardiopulmonary bypass.