BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages.OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases.METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups.RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time,intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week,3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes,while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases.

AIM:To investigate prevalence and causes of blindness and low vision of type 2 diabetes ( T2DM ) in Yangxin county, Hubei province.
METHODS: A total of 8 316 permanent residents, to carry out epidemiological survey of blindness and low vision. Carolina First T2DM patients were in the observation group, the other subjects admitted to the control group. Prevalence and etiology of blind and low vision were compared. Then the data only in the observation group were analyzed.
RESULTS: The rate of blindness and low vision appeared significantly higher, cataracts and retinopathy appeared significantly higher. With the increases of age, prevalence of blindness and low vision appeared significantly increased in the observation group. The rate of low vision was higher in women. Blind and low vision appeared significantly higher in junior high school educations. The above analysis was statistically significant (P<0. 05).
CONCLUSION: The prevalence of blindness and low vision of T2DM patients in our region were significantly higher than the unconsolidated. Blind and low vision in T2DM patients has a certain relationship with age, sex, education.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To evaluate the value of Multi-slice spiral CT angiography for spinal cord vessels.Methods 11 adult subjects with suspected of myelopathy were performed with Multi-slice spiral CT angiography,An iodine contrast agent was injected at 3.5 ml/s,for total 100 ml.The parameters were axial 16 slice mode,0.625 mm slice thickness,0.8 s rotation,delay time depending on smartprep (15—25 s), multi-phase scan.The coronal and sagittal MPR and SSD were generated on a workstation compared with spinal digital subtraction angiography (DSA) to analyze normal or abnormal spinal cord vessels.Results Normal findings at spinal CTA and digital subtraction angiography in six adult normal subjects and spinal cord vascular malformations( 1 intradural extramedullary AVF,4 dural AVFs) in five cases,Recognizable intradural vessels corresponding to anterior median (midline) veins and/or anterior spinal arteries were show in six adult normal subjects.Abnormal intradural vessels were detected in all five spinal cord vascular malformation with CT angiography ,in comparison with digital subtraction angiography these vessels were primarily enlarged veins of the coronal venous plexus on the cord surface,radiculomedullary-dural arteries could not be clearly shown in four dural AVF,only one anterior spinal artery was detected in one patient with intradural medullary AVF,which direct shunt between anterior spinal artery and perimedullary vein with tortuous draining vessel.Conclusion Multi-slice CT angiography is able to visualize the normal or abnormal spinal cord vessels.It could be used as a noninvasive method to screen the spinal cord vascular disease.

Objective To investigate the efficacy of gelatin sponge particles(GSP)or polyvinyl alcohol particles (PVA) for hemoptysis secondary to bronchiectasis or pulmonary tuberculosis. Methods The clinical data on 271 patients with bronchiectasis- or tuberculosis-induced hemoptysis were retrospectively analyzed. The efficacy and rates of recurrence and complications were analyzed. Results A total 271 patients were included in this study, 176 of whom suffered from bronchiectasis and the rest 95 had tuberculosis. One-week cure rate was signifi-cantly higher in bronchiectasis group than in tuberculosis group(73.3%vs. 46.3%,P<0.05),and one-year recur-rence rate was significantly lower in bronchiectasis group(17.6%vs. 26.3%,P<0.05). One-year recurrence rate was slightly higher in patients receiving GSP than in those undergoing PVA(bronchiectasis group:22.2%vs. 10.3%, P<0.05;tuberculosis group:28.8%vs. 22.2%,P>0.05). No severe complications occurred. Conclusions In-terventional artery embolization therapy for hemoptysis secondary to bronchiectasis is better than tuberculosis-induced hemoptysis,and PVA is more effective than GSP. Recurrence of massive hemoptysis mostly occurrs within one month ,and most of the patients are complicated with blood supply and have a history of hemoptysis.

To analyze the global structural models of point prescription in acupuncture therapy, and to provide new insights for acupoint selection based on syndrome differentiation. Taking prescriptions in the commonly used textbooks as the resources, a directed network of point prescription according to syndrome differentiation was constructed. The network was visualized with Pajek 1.25, the linkage distributions of points and symptoms were analyzed with Matlab 7.0. The result showed that there existed 1 635 combinations between 233 syndromes and 232 acupoints. The linkages of symptoms and selection of acupoints confirmed to the feature of random distribution with 5 points for each symptom in average. And the linkages obeyed a power-law distribution, which indicates that most symptoms can be treated by selecting a few points. Thus, it was concluded that complexity can be found in the global structural of relation between syndrome differentiation and acupoint selection. The selection of acupoints for every symptom and the matching of symptoms for every acupoint had different distribution patterns. The former obeyed a random pattern while the latter had a scale-free property. The complex network analysis is promised to be an available tool for researches on acupuncture prescriptions.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Syndrome

OBJECTIVETo observe the clinical effect of Pifubing Xuedu Pill (PXDP) combined with Diyin Tablet (DYT) in treating patients with psoriasis.

METHODSSixty patients were divided into 2 groups by randomized controlled method. DYT was orally taken by all patients, while XDP was given additionally to patients in the treated group, the medication was continued for 1 month. The therapeutic effect, toxic and adverse reaction were observed.

RESULTSIn the treated group, 7 patients were cured, 11 basically cured, 4 markedly effective, 7 improved, and 1 ineffective, with the clinical cured rate of 60.0% and the total effective rate 73.3%. In the control group, 3 were cured, 4 basically cured, 9 markedly effective, 10 improved, and 4 ineffective, with the clinical cured rate of 23.3% and the total effective rate 53.3%. No significant difference was shown in comparison of the total effective rate between the two groups (chi2 = 0.27, P > 0.05), however, significant difference was shown in comparison of the clinical cured rate (chi2 = 6.48, P < 0.05) between them. The toxic and adverse reaction in the treated group was obviously lower than those in the control group (t = 5.27, P <0.05).

CONCLUSIONDYT combined with PXDP in treating psoriasis shows better therapeutic effect, with quicker initiation, lesser toxic and adverse reaction, and higher efficacy than using DYT alone.

Adolescent ; Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Phytotherapy ; Psoriasis ; drug therapy ; Tablets

ObjectiveTo study the relationship between C-erbB-2 and estrogen (ER) and progesterone (PR) receptors, and the relationship between C-erbB-2, ER, PR with histologic grade. MethodsTo detect ER, PR and C-erbB-2 states by using immunohistochemical analysis and fluorescence in situ hybridization for C-erbB-2 in 163 unselected invasive breast carcinomas. ResultsC-erbB-2, ER ,PR were expressed in 21.5％ ,64.4％ ,44.2％ of 163 cases respectivly . 5 pure mucinous carcinomas , 3 tubular carcinomas and 1 micropapillary carcinoma were ER + ( 100.0％ ) 、C-erbB-2 - ( 100.0％ ) and PR + (40.0％ ,66.7％, 100.0％ ). C-erbB-2 was positive in 22.3％ of grade Ⅱ and 27.0％ of grade Ⅲ invasive ductal carcinomas and negative in all grade Ⅰ invasive ductal carcinomas.ER and PR expression were decreased significantly in C-erbB-2 + tumors compared with C-erbB-2 - tumors( ER,25. 7％ vs 75.0％ ; PR,25.7％ vs 49.2％ ). Although ER or PR expression is decreased in C-erbB-2 + tumors, a substantial proportion of them still express ER or PR. ConclusionC-erbB-2 overexpression or amplifcation was limited to a minority of invasive breast carcinomas. Tumour grade was an independent predictor for ER expression. ER was expressed in small number of high-grade and in large number of grade Ⅰ invasive ductal carcinomas. C-erbB-2 overexpression or amplification essentially was limited to grades Ⅱ and Ⅲ ductal carcinomas and correlated inversely with ER or PR expression.

[ ABSTRACT] AIM:To investigate the role of encapsulated protein transfected into human bone marrow mesen-chymal stem cells ( hBMSCs) by polyethyleneimine ( PEI) , and to optimize the best mole ratio of PEI-proteins.METH-ODS:6 groups of DNase I-PEI complexes were constructed and the best mole ratio was explored by laser scattering analy-sis.The appearance of complexes was presented under transmission electron microscope.Meanwhile, 4 groups of construc-ted GFP-PEI complexes were utilized to transfect into the hBMSCs, which were isolated and expand in vitro.The fluores-cence intensity of transfected cells was observed under confocal microscope.In addition, the cytotoxicity of the complexes on the cell proliferation was detected by MTT assay.The activity of the intracellular proteins was testified by aβ-galactosi-dase staining experiment.RESULTS:When the mole ratio of PEI and protein was adjusted to 4∶1, the complex transfec-tion efficiency was the best, and β-galactosidase color test turned blue.CONCLUSION:PEI has the character of encap-sulating various proteins to nano-complexes.The proteins transfected into bone marrow mesenchymal stem cells are con-firmed to have functional activity.As a protein carrier, PEI is of high efficiency and low toxicity, thus providing a new way for stem cell reprogramming.

Objective To investigate the feasibility and clinical effect of cannulated screws plus separate vertical wirings technique for acute fracture of the inferior pole of the patella.Methods From May 2012 to September 2013,14 patients with fresh closed unilateral fracture of the inferior pole of the patella were treated with the cannulated screws plus separate vertical wirings.Eight patients were injured in traffic collisions and 6 in fall accidents.Fracture AO classification was type 34A1 in 8 patients and type 34A2 in 6 patients.Time from injury to operation was 1-7 days (mean,2.5 days).Number of tie wires was determined according to the degree of fracture comminution.Fracture healing,fixed position and patellar length were evaluated by radiographic examination postoperatively.Knee mobility and Bostman evaluation system were investigated to analyze the clinical effect.Results All the patients obtained average 15-month follow-up (range,12 to 29 months).At postoperative 2 months,the fracture healed with good alignment of the broken bone and proper place of the internal fixation device noted on the X-ray films.At postoperative 6 and 12 months,X-ray films revealed fracture bony healing,good location of the wire internal fixation,and no apparent shortening of the patella.At the 12 months,range of knee motion was (126.0 ± 4.5) ° for flexion and (2.0 ± 1.7) ° for extension.Bostman functional score for patella fracture was (28.1 ± 1.9) points.And 12 patients were rated as excellent and 2 good,with excellence rate of 100％.Conclusion Cannulated screw fixation plus separate vertical wiring is effective to stabilize patella inferior pole fracture and has good results,indicating a recommended surgical method.