Objective To investigate the therapeutic effect and analgesic mechanism of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture.Methods80 cases of patients with painful osteoporotic thoracolumbar vertebral compression fracture in Shaoxing second hospital from May 2014 to May 2016 were selected, they were randomly divided into percutaneous vertebroplasty group (40 cases) and conservative treatment group (40 cases) two groups, the clinical efficacy, VAS scores and ODI scores of the two groups were statistically analyzed.ResultsThe total treatment effective rate of the percutaneous vertebroplasty group 95% (38/40) was significantly higher than the conservative treatment group (30/40) (P<0.05);The VAS scores and ODI scores of the two groups after treatment were significantly lower than before treatment (P<0.05);The differences of VAS scores and ODI scores before treatment between the two groups were not significant.The VAS score and ODI score after treatment of the percutaneous vertebroplasty group were significantly lower than the conservative treatment group (P<0.05).ConclusionThe therapeutic effect of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fractures is more significant than conservative treatment, it has better analgesic effect, so is worthy of promotion in the clinical.

Objective: To investigate the feasibility and advantages of supraclavicular approaching thyroidectomy for benign thyroid diseases. Methods: From February 2004 to December 2007, 64 cases of thyroidectomies were performed via the lateral cervical supraclavicular incision, and were selected as experimental group, of whom, there were 37 cases of thyroid adenomas and 27 cases of nodular thyroid goiters, respectively. At the same time period, 63 cases of consecutive thyroidectomies through the conventional anterior neck incision were selected as a control group, of whom, there were 39 cases of thyroid adenomas and 24 cases of nodular thyroid goiters, respectively. Results: All the operations in two groups were successfully accomplished. In the experimental group, there were 9 subtotal thyroidetomies, 40 subtotal lobectomies and 15 nodulectomies. While in the control group, there were 8 total thyroidetomies, 37 subtotal lobectomies and 18 nodulectomies. The statistical analysis between the two groups was carried out in terms of tumor size, operative time-consuming, blood loss, postoperative drain volume, time for return of motion and postoperative complications. There were no injuries of laryngeal recurrent nerve, superior laryngeal nerve and parathyroid glands. Two cases of postoperative complications in the experimental group and 3 in the control group were observed, respectively, the statistical differences were not significant between the two groups. Conclusion: The supraclavicular incision for thryoidectomy for benign thyroid diseases is a feasible and safe technique with a satisfactory cosmetic result. It is accessible to the treatment of bilateral thyroid diseases and can facilitate the detection of lymphatic metastases.

Objective To evaluate the efficacy and value of mediastinoscopy in the diagnosis of superior vena cava obstruction syndrome (SVCOS). Methods 12 patients with SVCOS underwent mediastinoscopy. This group consists of 9 males and 3 females aged 16 to 71 years. 7 cervical mediastinoscopies and 5 parasternal mediastinoscopies were performed. Results In eleven patients, definite pathological diagnosis was obtained, included: primary lung cancer in 8, lymphoma in 3 and invasive thymoma in 1. There were no operative morbidity and mortality. Only in 1 patient with lymphoma the symptom got worse after cervical mediastinoscopy and soon released by chemotherapy. Conclusion Mediastinoscopy is an effective method in the diagnosis of SVCOS.It can be considered as a routine procedure if other methods failed.

Objective:To evaluate the role of miR-124 in breast cancer and its underlying mechanism. Methods:Quantitative re-verse transcription-polymerase chain reaction (qRT-PCR) was employed to quantify the expression level of miR-124 in the breast can-cer cell lines and matched tissues of 52 patients. Cell proliferation, invasion, and migration of MDA-MB-231 and T-47D were deter-mined by miR-124 overexpression in vitro. Luciferase vectors (pMIR-SP1 3'UTR) were also constructed. The predicted target gene of miR-124 was identified via luciferase activation assay. The mRNA and protein expression of SP1 was detected via qRT-PCR and West-ern blot, respectively. Results:MiR-124 was decreased in breast cancer tissues and cell lines. This result is correlated with metastatic capacity, TMN stages, and prognosis in breast cancer tissues. In breast cancer cell lines, ectopic overexpression of miR-124 inhibited cell proliferation, invasion, and migration in vitro. MiR-124 mimics significantly inhibited luciferase activation (P<0.05) in HEK293 cells and could significantly decrease the mRNA (P<0.05) and protein expression levels of SP1 in MDA-MB-231 and T-47D cells. Con-clusion:MiR-124 could be inhibited in breast cancer. The low miR-124 expression is associated with poor prognosis. In addition, miR-124 could inhibit cell proliferation, invasion, and migration by targeting SP1. These findings confirm that miR-124 downregulation may be a key mechanism for breast cancer carcinogenesis.

Objective To investigate the current situation and development of geriatrics in Jiangsu Province, and to find out the characteristics and trend in development of geriatrics in Jiangsu Province. Methods The literatures in geriatric field of Jiangsu Province from 1998 to 2007 were collected from the database, www. cnki.net. Bibliometric methods and Mann-Whitney Test (performed by SPSS) were used to analyze the distribution of time, area, author, fund and discipline of the literatures. Results The total number of the literatures about geriatrics of Jiangsu Province from 1998 to 2007 was 4623, accounting for 7.72% of the total number of the literatures about geriatrics of China. The number of the literatures in South Jiangsu was the highest, followed by North Jiangsu and Center Jiangsu (P＜0.001). The authors publishing only one article made up 81.51% of the total number of the authors. The literatures with cooperating affiliations made up 12.24% of the total literatures. There were 212 literatures with research sponsorship. The literatures in geriatrics of Jiangsu province covered 39 subjects, and the literatures about cardiovascular diseases accounted for 14.56%. Conclusions Geriatrics in Jiangsu province shows a slow development and an imbalance between different areas and subjects. The core author team does not exist. This suggests that Jiangsu Province should increase the investment, and carry out a large and cooperating researchplan to promote the development of geriatrics in Jiangsu province.

Objective To compare the effects of fentanyl,sufentanil and remifentanil on the immune function of dendritic cells in human umbilical cord blood.Methods Human umbilical cord blood mononuclear cells were obtained by density gradient centrifugation and seeded in 24-well plates with a density of 1 × 106/ml (2ml/hole).The cells were randomly divided into 7 groups (n =15 each):control group (group C),fentanyl 1.0 ng/ml group (group F1),fentanyl 5.0 ng/ml group (group F5),sufentanil 0.1 ng/ml group (group S1),sufentanil 0.5 ng/ml group (group S5),remifentanil 1.0 ng/ml group (group R1),and remifentanil 5.0 ng/ml group (group R5).The cells were incubated for 10 days in serum-free culture medium containing 50 ng/ml recombinant human granulocyte colony stimulating factor,10 ng/ml recombinant human interleukin-4 or the corresponding concentration of fentanyl,sufentanil or remifentanil,and then 50 ng/ml recombinant human tumor necrosis factor alpha was added to the culture medium and the cells were incubated for another 4 days in the seven groups.Three holes in each group were chosen and the cell morphology was examined with inverted microscope.Six holes in each group were chosen for determination of the concentration of IL-12 in the supernatant and expression of CD80/CD86.Six holes in each group were chosen for measurement of the cell viability.Results Compared with group C,the concentration of IL-12 and cell viability were significantly decreased and the expression of CD80/CD86 was down-regulated in groups F5,S1,S5,R1 and R5 (P ＜ 0.05).The concentration of IL-12,cell viability and expression of CD80/CD86 were significantly lower in groups S1 and R1 than in group F1 (P ＜ 0.05).Compared with group F5,the concentration of IL-12 was significantly decreased in group S5,and the concentration of IL-12 and cell viability were significantly decreased and the expression of CD80/CD86 was down-regulated in group R5 (P ＜ 0.05).The concentration of IL-12 and cell viability were significantly lower in group R1 than in group S1 (P ＜ 0.05).The concentration of IL-12,cell viability and expression of CD80/CD86 were significantly lower in group R5 than in group S5 (P ＜ 0.05).Conclusion Remifentanil has stronger inhibitory effect on the immunological function of dendritic cells in human umbilical cord blood than sufentanil,and the inhibitory effect of sufentanil is stronger than that of fentanyl.

Influenza is a major threat to millions of people worldwide. Vaccines and antiviral agents are two main options available to reduce the impact of the influenza virus, while anti-influenza agents are the most effective means to prevent the transmission of the highly contagious virus and to treat the epidemics of disease. At present, four anti-influenza agents have been approved by the FDA for the treatment of influenza, including two M2 protein ion channel inhibitors-amantadine and rimantadine and two neuraminidase inhibitors-zanamivir and oseltamivir. Arbidol hydrochloride, launched in Russia, is a potent inhibitor of influenza virus, too. Neuraminidase inhibitors could be classified generally by structure into six different kinds: sialic acid derivatives, benzoic acid derivatives, cyclohexene derivatives, cyclopentane derivatives, pyrrolidine derivatives and natural products. In this paper, recent progress in the research of the action mechanisms and structure-activity relationships of these anti-influenza virus agents were reviewed.

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.

Objective To investigate causes and treatment strategy of cage retropulsion after lumbar interbody fusion,in particular the correlations between the injury of the posterior part of endplate cranially adjacent to fusion and cage retropulsion.Methods Data of 7 patients with cage migration after lumbar interbody fusion from August 2011 to July 2014 in our hospital were retrospectively analyzed.There were 4 males and 3 females,aged from 45-74 years (average,53.6 years).All patients took X-ray and CT scans examinations 3 d postoperatively,and they were followed up at 3,6,12 months after operation.The characteristics of the patients and the injury of the endplate adjacent to fusion were analyzed to identify possible risk factors of cage retropulsion.Moreover,corresponding managements were performed and outcomes were recorded.Results All 7 cases of cage retropulsion occurred within 3 months post-operatively (rang,15-67 d).Posterior part of the endplate superiorly neighboring to fusion was found injured on the decompression side in all cases with cage retropulsion,and that led to an increase in the posterior intervertebral space height at the fusion segment.Other factors,including pear-shape type endplate,and improper operative manipulations may add the risk of cage retropulsion.These 7 patients complained mild back pain or no back pain,and received corresponding treatments including bed rest,activity limitation,and oral administration of anti-inflammatory analgesics.The clinical symptoms and degrees of cage retropulsion were not aggravated during follow-up.Conclusion The injury of the posterior margin of end-plate superiorly neighboring to fusion on the decompression side which caused increased posterior intervertebral space height may be key to postoperative cage retropulsion.Prevention of possible iatrogenic injury to the endplate may be effective to reduce the risk of cage retropulsion.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.