Objective To compare clinical outcomes of percutaneous endoscopic lumber discectomy ( PELD ) versus minimally invasive transforaminal lumbar interbody fusion ( Mis-TLIF ) under the Quadrant system in the treatment of lumbar disc herniation. Methods From January 2010 to December 2013, 60 patients with lumbar disc herniation and failed to conservative treatment were enrolled in this study.According to the random number table, the patients were divided into two groups, with 30 patients in each group.There were no significant differences in age, gender, segment of disease, clinical diagnosis, and imaging results between the two groups (P >0.05).The surgery of PELD under the TESSYS endoscopic system or Mis-TLIF under the Quadrant system was performed by a same surgical team.Follow-up was conducted for 12-24 months (mean, 16.2 months).The operation time, blood loss, hospital stay, visual analogue scores (VAS) for back and leg pain, Oswestry disability index (ODI), Japanese Orthopaedic Association ( JOA ) scores, MacNab criteria, and complications were compared between the two groups. Results As compared with the Mis-TLIF group, the PELD group had significantly shorter operation time [(72.0 ±18.7) min vs. (137.0 ±48.3) min, t=-6.857, P=0.000], less intraoperative blood loss [(28.0 ±14.7) ml vs.(314.0 ±13.6) ml, t=-11.831, P=0.000], and shorter hospitalization stay [(4.0 ±1.0) d vs.(10.0 ±3.0) d, t=-9.298, P=0.000].The scores of VAS of back and leg pain at 2 weeks and 3 months postoperation in the PELD group was lower than the Mis-TLIF group (P<0.05). The scores of ODI and JOA at 3 and 12 months postoperation in the PELD group were superior to the Mis-TLIF group (P<0.05).No significant difference was recorded in the MacNab criteria at 12 months postoperation between the two groups (P>0.05).There wasno significant difference in complication rate between the two groups. Conclusions Both PELD and Mis-TLIF are safe and effective for lumbar disc herniation.PELD has smaller incision, shorter operation time, and less blood loss as compared with Mis-TLIF.

The myocardial protection technique of off-pump coronary artery bypass grafting ( OPCABG ) has been applied to the coronary artery bypass grafting (CABG) with heart valve surgery.This study is aimed at determining its clinical effect .A retrospective analysis design was adopted .39 patients were recruited .All patients ’ surgeries went smoothly but one ,whose blood pressure was in poor control after surgery and then returned to normal after as -sisted with intra-aortic balloon counterpulsation (IABP).Others had stable vital signs and circulation .Finally,all pa-tients discharged safely .Significant improvement can be seen during 3 months’ follow-up.Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic .

Objective To approach the expression and significance of connection tissue growth factor(CTGF) in articular cartilage after full-thickness osteochondral defect on the medial femoral condyle in young and adult rabbits model.Methods Totally 25 young(at an age from 10 to 12 weeks) and 25 adult New Zealand white rabbits(at an age from 34 to 39 weeks) were randomly divided into 5 groups(n=5) ,control group,24-hour,1-week,4-week and 8-week after full-thickness cartilage injury groups.A rabbit model of spontaneous healing of full-thickness cartilage defect in the medial femoral condyle in both knees was reproduced.Macroscopic and histological morphous of repairs were observed in each age group during repair.mRNA and protein expression of CTGF were detected with RT-PCR and immunohistochemistry,respectively.Results The morphologically good repairs with hyaline-like cartilage appearance were observed in young rabbit,but formation of fibrous tissue in adult rabbit.The expression of CTGF mRNA was detected in all groups.Expression of CTGF mRNA was significantly higher in young rabbit than in adult rabbits(P

Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.

Objective The objective of this study was to investigate the clinicopathological features and rational treatment of primary fallopian tube cancer(PFTC).Methods The clinical and pathological data of 39 patients with primary fallopian tube cancer from January 2006 to July 2016 in Beijing Tongren Hospital of Capital University were retrospectively analyzed.Results There were 39 cases of undifferentiated carcinoma,including 1 case of undifferentiated and transitional cell carcinoma,37 cases of undifferentiated adenocarcinoma,or 29 cases of simple adenocarcinoma and 10 cases of mixed type.Among them,7 cases were treated with clear cell carcinoma,endometriosis in 2 cases,combined with transitional cell carcinoma in 1 case.Extra-pelvic metastases were the most common site of the omentum with 17 cases.The preoperative test CA125 was increased in 13 cases and 38 patients received postoperative chemotherapy.The 5-year overall survival rate of 39 patients was 51.3%.Univariate analysis showed that postoperative pathologic stage(Ⅰ~Ⅱ vs.Ⅲ,P<0.001),intraoperative residual lesion size(P<0.001),omentum metastasis(P<0.001),ovarian metastasis(P=0.034),retroperitoneal lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were associated with prognosis,while age(P=0.310)and pathological grade(P=0.663)were not associated with prognosis.Multivariate analysis showed that the number of patients with postoperative lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were correlated with prognosis(HR=1.202,95% CI:2.354~63.290,P=0.003) and pathological stage(HR=3.810,95% CI:1.202~12.079,P=0.023).They were associated with prognosis as independent prognostic factors.Conclusion Tumor pathologic staging and omentum metastasis are important prognostic factors influencing the prognosis of patients with primary fallopian tube cancer.Early diagnosis and complete operation can improve the prognosis of patients.

Objective:To evaluate the protection of small bowel and bladder by Contoura carbon fiber belly board in patients with rectal cancer undergoing postoperative radiotherapy and the position deviation during radiotherapy. Methods: This study enrolled 45 consecutive patients with rectal cancer who had undergone prior surgery. Twenty patients who applied the belly board were defined as group A, and the other 25 patients were defined as group B. All the patients received threE-dimensional conformal radiation therapy(3D-CRT), and the prescriptive radiation dosage of 95% of planning target volume (PTV) was 50 Gy/25 times. Patients in group A underwent two sets of CT scans as follows: group A1, prone alone; group A2, prone with the use of the belly board. The radiation dosage and radiated volume in PTV, small bowel, and bladder were observed by dosE-volume histograms. Ten patients were selected randomly from group A and group B, respectively. Their position deviation during radiotherapy was measured by double exposure field verification system. The acute radiation reactions of all patients were observed and recorded during radiotherapy. Results: No significant difference was found in the total PTV and total volume of small bowel and bladder and mean irradiation dosage to PTV between groups A1 and A2. The mean irradiation dosage to the small bowel and bladder, the volume of small bowel irradiated at 10%-100% dose levels, and the volume of bladder irradiated at 30%-100% dose levels, were significantly decreased in group A2. The difference was significant. Compared with group B, the right-left and superior-inferior position deviations were significantly reduced in group A. The difference was significant (P<0.05). The anterior-posterior position deviation was also reduced, but the difference was not significant (P=0.705). The incidence of grade 3 or more adverse reactions were 15% (3/20) in group A and no patient broke off or stopped treatment; the incidence of grade 3 or more adverse reactions was 24% (6/25) in group B, and two patients broke off the treatment because of severe adverse reaction. One patient terminated the treatment. Conclusions: The Contoura carbon fiber belly board can reduce the irradiation dosage and volume of small bowel and bladder in patients with rectal cancer undergoing postoperative radiotherapy. The position deviation has better reproducibility and the acute radiation reactions are tolerable. It is worthy of application in clinic.

AIM To investigate the effects of safflower yellow on myocardial injury in patients with severe sepsis.METHODS Using prospective research methods,ninety-two patients with severe sepsis treated in our hospital from Jan.2013 to Mar.2016 were divided equally into two groups:control group (routine treatment) and observation group (routine treatment + safflower yellow).In addition,6 and 72 hours after the treatment,heart-type fatty acid binding protein (H-FABP),creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of patients were detected,and the changes of left ventricular ejection fraction (LVEF) and sequential organ failure assessment (SOFA) scores were observed;length of ICU stay,cumulative incidence of major adverse cardiac events (MACE) and 28-day survival also were recorded at the same time.RESULTS In admission,there were no differences in the levels of H-FABP,CK,CK-MB and LVEF,SOFA scores between the two groups.After 6 hours treatment,the levels of H-FABP,CK,CK-MB and SOFA score in the observation group were lower than those in the control group;the two groups had higher levels of H-FABP,CK and CK-MB than those before the treatment,SOFA score was lower than that before the treatment;After 72 hours treatment,H-FABP,CK,CK-MB and SOFA score were lower than those after 6 hours treatment;SOFA score in the observation group was lower than that in the control group;there were no differences in H-FABP,CK and CK-MB between the two groups.The observation group had a lower cumulative incidence of MACE than the control group.There was no statistical difference in LVEF and length of ICU stay after the treatment between the two groups.The observation group had a higher 28-day survival than the control group,the difference was statistically significant (76.08％,35/46 vs 54.35％,25/46;x2 =4.529,P =0.033).The level of serum H-FABP in severe sepsis patients was negatively correlated with LVEF (r =-0.270,P =0.009).CONCLUSION Therapeutic effects of safflower yellow on myocardial injury in patients with severe sepsis is superior to routine treatment with the improvement of the prognosis of patients to a certain extent.

BACKGROUND:Hereditary factor occupies a certain position in suicidal behavior of depression. The researches in the past are focused on the hereditary effect on bipolar depression suicide.How do hereditary patterns and effects work in suicidal behavior in unipolar depression?OBJECTIVE: To probe into hereditary patterns and effects on suicidal behavior in unipolar depression.DESIGN:Retrospective investigation.SETTING:A municipal psychiatric hygienic centerPARTICIPANTS:Unipolar depression group included 115 outpatients and inpatients diagnosed in Wuxi Psychiatric Hygienic Center from June 1st 1983 to May 31st 2002.The diagnosis tallied with Standards on Depression Onset in Categories and Diagnostic Standards on Psychiatric Disturbance in China of 3rd Edition and with Standards on Severe Depression Onset in Manual of Diagnosis and Statistics of Psychiatric Disturbance in America of 4th Edition.The attack frequency of all the cases ≥ 3 times or the cases had been relieved ≥8 years after a couple of attacks.METHODS:The patients who tallied with the standards on unipolar depression received the investigation in every family tree under the instruction of 2 physicians-in-charge and more than 2 physicians and filled up the self-made investigation form of psychiatric family tree,including mainly the data of social demography of patients and their first grade relatives,characters of disease onset,frequency of attack,history of treatment and suicide. After re-diagnosed by 2 physicians-incharge and more than 2 physicians and checked by one physician-incharge,the cases were collected in patient group. The interview was carried on for the patients with suicidal behavior among all of the survived patients (107 cases) and first grade relatives (14 cases).The interview (337 cases) and investigation with letter (380 cases) were carried on for the first grade relatives without suicidal behavior. The investigation forms of 13 dead cases (8 cases of patients, 5 cases of first-grade relatives) were provided and filled-up by one or two first grade relatives. Two researchers interviewed the cases in the control,inquired the first grade relatives and filled up the investigation form of family tree.Single factor analysis was used for all the data and Falconer pattern of polygenetic threshold-value theory was used to estimate hereditary rate and standard error in suicidal behavior.Separation analysis in medical hereditary mathematic method and polygenetic threshold-value theory were applied to discuss the hereditary patterns.MAIN OUTCOME MEASURES:Hereditary effects and patterns of suicidal behavior in unipolar depressed patients.RESULTS:Suicidal risk of unipolar depressed patients(51.30%,59/115)was higher than their first grade relatives (2.58%,19/736) (x2=283.16,P ＜ 0.01).Suicidal risk of the first grade relatives (2.58%,19/736) of unipolar depressed patients was higher than the control (0.12%,3/2469)(x2=50.36,P ＜ 0.01).Suicidal risk of the first grade relatives of the patients with suicidal behavior (3.8%,14/372) was higher than that of the first grade relatives of the patients without suicidal behavior (1.4%,5/363)(x2=4.14,P＜ 0.05).The weighted average hereditary rate and standard error was (70.16±0.79)% for suicidal behavior in unipolar depression.The predictive morbidity of suicidal behavior in the first grade relatives was 3.1% and the real morbidity was 2.6%,which did not indicate significant difference (u =0.766, P ＞ 0.05).CONCLUSION:Suicidal behavior of unipolar depression presents obvious hereditary effects and its hereditary patterns tally with polygenetic inheritance.

Objective Laryngeal and upper esophageal foreign bodies are common diseases, we explored a new and simple method to remove these foreign bodies. Methods The clinical data of 177 patients with laryngeal and upper esophageal foreign bodies from June 2008 to January 2016 were analyzed retrospectively. We used two methods to treat these foreign bodies:130 foreign bodies were directly removed under video endoscopy;47 foreign bodies were removed with suspension laryngoscopy, and video endoscopy was used meanwhile. Result 177 laryngeal and upper esophageal foreign bodies were removed well, without severe complications like esophageal perforation or phyryngeal fistula. Conclusion Removing esophageal and laryngeal foreign bodies with video endoscopy is simple, safe and effective.

Objective To investigate the endothelial dysfunction in pre-hypertension and its influencing factors.Methods A total of 373 youth were divided as the subjects into hypertension group (HBP group),prehypertension group (PHT group) and normal blood pressure group (NBP group).Endothelial function was assessed based on carotid intima-media thickness (IMT),brachial artery flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV).Results IMT and baPWV in PHT group were higher than those in NBP group (P＜0.05),but did not reach the significant difference when compared with HBP group (P＞0.05).Compared with HBP,the levels of FMD in PHT group significantly increased (P＜ 0.05);however,no difference was observed in comparison with NBP group (P＞0.05).In the early stage of hypertension,diastolic BP (β=-0.120,P＜0.05) and body mass index (β=-0.115,P＜0.05) were negatively correlated with FMD;diastolic BP (β=0.146,P＜0.05),2-hour glucose (β=0.147,P＜0.05),high-density lipoprotein cholestrol (β=0.150,P＜0.05),and waist-hip ratio (β=0.126,P＜0.05) showed a positive correlation with IMT.baPWV was correlated with systolicBP (β=0.358,P＜0.01),waist circumference (β=0.254,P＜0.05),fasting glucose (β=0.155,P＜0.05),postprandial 2 h blood glucose (β =0.152,P ＜0.05),uric acid (β =0.206,P ＜ 0.05),and C-reactive protein (β=0.099,P＜0.05).Corclusion Our study shows that endothelial dysfunction may exist in the prehypertensive young,and several cardiovascular risks contribute to its development in the early stage of hypertension.