BACKGROUND:Percutaneous vertebroplasty, percutaneous kyphoplasty and expandable pedicle screw fixation can treat primary osteoporotic thoracolumbar fractures. The three methods have their own advantages and disadvantages. OBJECTIVE:To investigate the methods and clinical effects of primary osteoporotic thoracolumbar fractures. METHODS:Clinical data of 61 patients with primary osteoporotic thoracolumbar fractures were col ected and retrospectively analyzed. Perioperative preparation must be done. Al patients were treated by percutaneous vertebroplasty, percutaneous kyphoplasty and expansive pedicle screw fixation. We recorded Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) before treatment, 3 months after treatment, as wel as sagittal index (SI) and Cobb angle of vertebral fracture before treatment, 3 days and 3 months after treatment. RESULTS AND CONCLUSION:(1) Al cases were fol owed up for 12-18 months. (2) There was no significant difference in VAS scores, ODI, SI and Cobb angle of vertebral fracture among the three groups of patients preoperatively. (3) At 3 months after treatment, there were significant differences in VAS scores and ODI in the three groups as compared with that preoperation (P<0.05). However, no significant difference in VAS and ODI was determined among intergroup comparison (P>0.05). (4) SI and Cobb angle of vertebral fracture were significantly increased;the difference was statistical y significant (P<0.05). The efficacy was similar between the percutaneous kyphoplasty and expansive pedicle screw fixation groups (P>0.05), and was better than the percutaneous vertebroplasty group (P<0.05). (5) Three kinds of treatment can effectively restore the vertebral height and intensity, relieve pain and stabilize the spine, and no significant vertebral compression was found in the short term. However, restoration of postoperative vertebral height was better in percutaneous kyphoplasty and expansive pedicle screw fixation groups than in the percutaneous vertebroplasty group. In view of their respective indications, advantages and disadvantages, the key point of raising therapeutic effect was to choose appropriate surgical procedures.

BACKGROUND:During cervical posterior expansive open-door laminoplasty for multisegmental cervical spondylosis, spinal canal restenosis, loss of cervical lordosis, and axial symptoms are the important factors affecting curative effects. It is very necessary to maintain spinal canal expanded state and to reduce interference of the posterior cervical structure in the clinical treatment. OBJECTIVE:To observe clinical outcomes and short-term fol ow-up effect of posterior expansive open-door laminoplasty via titanium miniplate in treatment of cervical spondylotic myelopathy. METHODS:A total of 67 patients with cervical spondylotic myelopathy who underwent posterior expansive open-door laminoplasty at the Zhongshan Hospital, Xiamen University from April 2006 to April 2013 were retrospectively analyzed. Titanium miniplate group (n=27) received titanium miniplate fixation. Suture group (n=40) received traditional suture suspension. Al patients had decompression ranged from C 3-7 . Operation time, intraoperative blood loss, improvement rate of Japanese Orthopedic Association score during fol ow-up, value of cervical curvature, axial symptoms, and lamina opened angle were compared between the two groups. RESULTS AND CONCLUSION:No significant difference in operation time, intraoperative blood loss and improvement rate of Japanese Orthopedic Association score was detectable between two groups (P>0.05). Cervical curvature changes in both groups:loss of cervical curvature at 6 months postoperation was not significant in the titanium miniplate group, but cervical curvature partial y lost in the suture group, and significant differences in the cervical curvature were detected between the two groups (P<0.05). The incidence of axial symptoms was significantly lower in the titanium miniplate group than in the suture group at 6 months after surgery (P<0.05). During final fol ow-up, no significant difference in the lamina open-angle was detected between titanium miniplate group (35.2±6.2)° and suture group (34.0±4.7)° (P>0.05). These data suggested that posterior expansive open-door laminoplasty for treatment of cervical spondylotic myelopathy using both titanium miniplate and suture methods can obtain good clinical outcomes. However, titanium miniplate fixation can relieve postoperative axial symptoms and prevent loss of cervical curvature.

Purpose To explore the relationship between tumor suppressor in lung cancer 1 (TSLC1) protein expression and the carci-nogenesis and progression of human gastric carcinoma. Methods Expression of TSLC1 protein in 20 normal gastric mucosa, 30 intra-epithelial neoplasias ( IN) and 50 gastric cancers was examined by immunohistochemistry. Results The expression of TSLC1 in gas-tric cancer was 14. 00% which was lower than that in IN (46. 67%) and normal gastric mucosa (95. 00%, P<0. 05). TSLC1 ex-pression in high-grade IN was lower than that in low-grade IN and normal gastric mucosa (P<0. 05). TSLC1 expression in high-grade IN and gastric cancer was of no significant difference ( P>0. 05 ) . Expression of TSLC1 was significantly associated with lymph node metastasis and TNM in gastric cancer (P<0. 05). Conclusion The expression of TSLC1 is closely related to carcinogenesis, lymph node metastasis and clinical stage in gastric cancer, which suggest that TSLC1 may be a new target for the prevention and treatment of gastric cancer.

BACKGROUND:Mobile-bearing prosthesis has advantages in theoretic design, in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes are better than fixed-bearing prosthesis at present. OBJECTIVE:To evaluate the medium-term results of total knee arthroplasty using mobile-bearing prosthesis to provide clinical evidence for the choice of prosthesis. METHODS:The patients who suffered from osteoarthritis or rheumatoid arthritis and underwent total knee arthroplasty with PFC Sigma RP in Beijing Tongren Hospital from December 2006 to June 2009 were included in this study. The postoperative Knee Society Score, Knee Society Score Function Score, Patel ar Score and the Pain Score, range of motion, maximun flexion and extension angle were col ected and compared with pre-operation. The complications, such as infection, patel a clicking, polyethylene insert dislocation, and deep vein thrombosis were recorded after replacement. The anterior-posterior, lateral and Merchant position X-ray images were taken to evaluate the tibiofemoral alignment, radiolucent lines, and patel ar dislocation. Then, the results of other medium-term fol ow-up researches were compared with fixed-bearing arthroplasty. RESULTS AND CONCLUSION:Final y, 31 patients (45 knees) were fol owed up. The average age was 64.56±10.33 years, and fol ow-up period was 3.9-7.6 years. The postoperative scores, range of motion, maximun flexion and extension angle were improved obviously, but there were no differences with other medium-term fol ow-up researches. No radiolucent lines, prosthetic loosening or polyethylene insert dislocation was found. Lateral patel ar release was done, but no patel ar dislocation or subluxation appeared in al patients. Two patients (2 knees) accompanied patel a clicking. Results indicated that the medium-term clinical result was satisfactory. No patel ar dislocation or subluxation was found, although only lateral patel ar release was done. This may be the superiority of mobile-bearing arthroplasty.

Objective To study prognosis of patients with fulminant hepatitis after plasma ex- change treatment using model for end-stage liver disease(MELD)scoring system.Methods 160 pa- tients were randomly divided into plasma exchange group and control group,and MELD score was calculated according to the original formula for each patient.The efficacy of plasma exchange was as- sessed by mortality and improvement in biochemical parameters and MELD score.Results The levels of total bilirubin(TBIL),INR and MELD score of patients whose MELD scores were between 30 and 40[TBIL,(379.4?40.4)?mol/L; INR,2.5?0.2; MELD,30.8?3.8]were lower than before PE treatment[TBIL,(509.7?64.6)?mol/L;INR,3.5?0.3;MELD,37.3?3.5].The levels of TBIL and INR and MELD score of patients whose MELD scores were higher than 40 [TBIL,(595.6?61.5)?mol/L;INR,3.8?0.4;MELD,39.8?3.5]were lower than before PE treatmem [TBIL, (650.4?66.3)?mol/L;INR,4.4?0.6;MELD,45.2?4.2].The mortality of patients in PE group with MELD score from 30 and 40 was 50.0%,while it was 86.7% in control group,showing significant differ- ence between PE group and control group(P＜0.01).The mortality of patients with MELD scores higher than 40 was 91.2% in PE group and 100% in control group,showing no significant difference between these two groups(P＞0.05).Conclusions Plasma exchange treatment can decrease the serum TBIL level, INR and MELD score of patients with fulminant hepatitis and improve liver function.Compared with the control group,plasma exchange can significantly decrease the mortality of patients in PE group with MELD score from 30 to 40,but no effect on patients with MELD score higher than 40.

Objective The feasibility and the curative effect of bipolar hemiarthroplasty for hemiplegic side femoral neck fractures in elderly patients were evaluated.Methods The patients suffering from hemiplegic side femoral neck fractures and undergoing bipolar hemiarthroplasty in Beijing Tongren Hospital were followed-up during 2012-2015.The postoperative Harris Score and the complications such as infection,deep vein thrombosis and dislocation were collected.Results Totally 25 patients(25 hips)were followed-up.The average age was 70.1 years,and mean follow-up period was 24.3 months (10-42 months).The mean Barthel index score was higher (77.4 ± 14.7,ranging from 40-95 points) after operation than before operation[25.00 ± 5.95 (15-35 points)] with a statistically significant difference(t=-21.374,P＜＜0.05).The postoperative Harris Score was 83.5± 8.9(60-95 points).According to Harris score,the excellent and good rate was 80.0％.The patient's satisfaction rate was 88.0％.Conclusions Choosing proper prosthesis and fixing measure,and keeping the function and tension of short extorsion muscles can achieve the satisfactory results for hemiplegic side femoral neck fractures in elderly patients.

Objective To investigate the effect of physical training on plasma N-terminal pro-brain natri- uretic peptide(NT-proBNP)levels in patients with chronic heart failure(CHF).Methods Eighty NYHAⅡ-ⅢCHF patients were randomly divided into a training group(n=42)and a control group(n=38).A 6-minute walk- ing test was performed within 24 hours after the patients were admitted.The 6-minute walking distance and plasma NT-proBNP levels were determined before and after 8 weeks of programmed physical training.The patients of both groups were treated with routine drugs for heart failure.6-minute walk training was only performed in the training group twice a day for 8 weeks.Results Physical training could significantly reduce plasma NT-proBNP levels and improve performance on the 6-minute walking test.Conclusions Physical training could significantly reduce plas- ma NT-proBNP levels and improve the motor function of patients with CHF,and could be helpful in delaying the de- velopment of CHF.

Objective To evaluate the operation methods and effects of transforaminal wedge osteotomy (TWO) combined with intervertebral grafting bone for correcting the rigid thoracolumbar kyphosis.Methods From January 2003 to June 2013, treatment of 52 cases of the rigid thoracolumbar kyphosis by TWO combined with intervertebral bone graft were studied (including 33 males and 19 females, and the age range was from 15 to 72 with average age of 42.3 years old).In these 52 cases, there were 17 cases of ankylosing spondylitis, 25 cases of obsolete thoracolumbarvertebral fractures, 7 cases of chronic thoracolumbar tuberculosis and 3 cases of congenital vertebral malformations.52 cases presented as lumbar kyphosis, low back pain aggravated,with an average VAS score of 8.6;24 cases were accompanied with different extent of neurological dysfunction which obviously influenced daily life or work.Osteotomy was located at thoracolumbar intervertebral disc.Pedicle screws internal fixation system combined with intervertebral grafting bone was used to compress the vertebra and fuse after TWO for correction.Preoperative and postoperative low back pain was evaluated by visual analog score (VAS), Frankel score and Oswestry disability index(ODI) in patients with neurological dysfunction.The above indexes were compared with the PSO osteotomy group.Results Preoperative mean kyphosis Cobb angle was 65.6°(31°-137°).The average post-operative kyphosis Cobb angle was 19.2° (8°-35°), and the average correction rate was 68.4％.The mean operation time was 3.8 h (2.2-5.3 h), and the mean intraoperative blood loss was 1220ml (500-2 900 ml).Preoperative VAS score was 8.6± 1.2 while the last follow-up was 1.8±0.5;preoperative Oswestry dysfunction index was 75.6±8.2 while the last follow-up was 18.4±8.1.The results were statistically significant.The spinal function was 4 cases of Frankel C and 20 cases of Frankel D before operation, all of which dropped to E level after operation.52 patients were followed up with the average time of 41 months (from 6 to 60 months).The bony fusion rate was 94.23％ at 6 months after operation.All of the patients were fused in 3 years after operation.The average loss of kyphosis Cobb angle was 5.5°(4°-12°).Compared with PSO, the average operation time, the amount of bleeding and the improvement of neurological function after surgery all had some advantages.Conclusion Transforaminal wedge osteotomy has many advantages, such as less bleeding wounds, less nerve interference and limited multi-segmental osteotomy, with little trauma and high bony fusion rate.

To establish a method for quantitative measurement of phagocytosis, the phagocytic process of apoptotic granulosa cells by monocytes was imitated in vitro. Monocytes and granulosa cells were isolated from Kunming mice and cultured. Granulosa cells were induced to apoptosis by garlic, and then co-cultured with monocytes. At different time points (1 h, 2 h, 3 h, 4 h, 5 h), co-cultured cells were observed by microscope after Wright's staining. The results showed that at the beginning of morphological changes in apoptotic granulosa cells, monocytes captured the apoptotic cells. Meanwhile, the apoptosis of granulosa cells were progressing. Debris was found in phagocytic vacuole. At the point of 3 h after co-culture, the ratio of monocytes which attached to apoptotic granulosa cells to those which engulfed the apoptotic cells was close to one. Namely, half of monocytes were in the state of recognition and half were in the state of engulfment, and this time point was named as 'half phagocytic period'. Regression analysis showed that the equation of linear regression was y = -0.247x +1.644 (y represents Attachment/Engulfment ratio, x represents co-culture time), R(2)=0.912, F=31.095, P=0.011 (<0.05), T= -5.576, P=0.011 (<0.05). In conclusion, the present mode of phagocytosis in vitro can be used as a method to quantitatively assay some effective factors such as medicines which could enhance or restrain phagocytosis.
Animals ; Apoptosis ; Coculture Techniques ; Female ; Granulosa Cells ; cytology ; Mice ; Monocytes ; cytology ; Phagocytosis