[Objective]To compare the difference of percutaneous kyphoplasty in treating osteoporosis compression fractures using the Sky Bone Expander system and the Balloon Bone Expander system,and evaluate its clinical efficacy.[Method]From October 2005 to October 2007,19 patients of osteoporosis compression fractures with intact posterior vertebral body were performed.Nineteen patients were infated while 9 as group A were balloon group and 10 as group B were SKY group,fracture reduction and bone cement augmentation were applied.Preoperative and postoperative symptom levels,variables,complications were recorded and the vertebral height,Cobb′s angle and VAS score were measured and analyzed.[Result]Pain in all patients was alleviated or disappeared without syndrome,and the vertebral height,Cobb′s angle and VAS score of both groups were improved.The contrast between preoperative and postoperative showed obvious differences(P0.05).[Conclusion]Kyphoplasty can provide early relief of pain and improve the function as well as spinal alignment in treating osteoporotic compression fractures owing to recovering the verteberal height and Cobb′s angle of the vertebral body.Balloon inflated kyphoplasty can improve osteoporolic compression fractures as SKY.

Objective To report the experience of using R 0 Swartz sheath in patients with tortuous and prolonged aorta. Methods The radiofrequency ablation procedure could not be done in 4 patients (3 patients with left side accessory pathway, and 1 with idiopathic left ventricular tachycardia) because the ablation catheter could not be put in left ventricle due to tortuous and prolonged aorta. We tried to use R 0 Swartz sheath in these patients in order to put the catheter into left ventricle via small curve of the R 0 Swartz.Results The ablation procedures were successful in these 4 patients by using R 0 Swartz.Conclusion Using R 0 Swartz sheath in patients with tortuous and prolonged aorta is helpful in making the left side ablation procedure successful.

In 4 602 subjects for routine check-up,blood uric acid,total cholesterol,triglyceride,high density lipoprotein-cholesterol,and low density lipoprotein-cholesterol were determined.Results showed that the overall prevalence of hyperuricemia in Nanning,Guangxi was 19.8％ (28.8％ in male,9.4％ in female).Blood uric acid and lipids in hyperuricemia group were higher than those in normal uric acid group(all P＜0.01).Serum uric acid had a positive correlation with total cholesterol,triglyceride,low density lipoprotein-cholesterol,but it was negatively correlated with serum high density lipoprotein-cholesterol.The prevalence of hypercholesterolemia was 30.8％,and that of hypertriglyceridemia was 22.2％.Logistic multi-factor regression analysis showed that men,high total cholesterol,triglyceride,and low density lipoprotein-cholesterol could be independent risk factors for hyperuricemia,and that high density lipoprotein-cholesterol was a protective factor.The prevalence of hyperuricemia in population of Nanning,Guangxi during health examination is high.Hyperuricemia is closely associated with dyslipidemia.Timely intervention of hyperuricemia can reduce the related diseases effectively.

Objective To investigate MR imaging characteristics of MELAS syndrome.Methods The clinical data and MRI features of 13 cases with MELAS syndrome were retrospectively analyzed.Results Multiple hypointense on T1WI and hyperintense on T2WI lesions were showed predominantly in the gray matter of the temporal, parietal and occipital lobes. The lesions crossed vascular boundaries. No stenosis and occlusion of main artery were displayed by MRA.Basal ganglia calcifications and cerebral atrophy with widening of ventricles were also frequent found. Increased ADC value of the leison on DWI and appearance of Lac peak on1H-MRS were useful in diagnosis.Conclusion There are some characteristics of MRI in patients with MELAS syndrome.Combined clinical informations with neuroimaging and muscle biopsy, the diagnosis of MELAS syndrome can be made correctly.

Objective To study the action and mechanism of staphylococcal exfoliative toxin A(E-TA)on pemphigus foliaceus antigen(PFA)and pemphigus vulgaris antigen(PVA)expressed on cultured human keratinocytes.Methods Stratified human keratinocytes were incubated with ETA and then stained with sera from patients with pemphigus foliaceus or pemphigus vulgaris as the first antibodies and FITC-la-beled sheep anti-human IgG as the second antibody.Total protein was harvested from the cells pretreated with ETA and run on SDS-PAGE for Western blot with the same antibodies.Simultaneously,supernatants of the keratinocytes before and after ETA treatment were collected for detection of the levels of IL-1?,IL-6with ELISA kits.The caseinolytic activities of the supernatants were tested by spectrometry in which casein was used as a non-specific substrate.Results Down-expression of PFA was shown after ETA treatment while no change of PVA expression was found.The high intensity and continuous linear appearance of fluo-rescent staining before ETA treatment became weak and discontinuous after ETA treatment,which were re-covered gradually in24hours.The degradation of proteins recognized by PF sera after ETV treatment was revealed by Western blot.The decreasing tendency of IL-1?concentration was found in the supernatants of cell culture after ETA treatment,but IL-6level was too low to be detected.Increased caseinolytic activities were found in the supernatants,and declined36hours after ETA treatment.Conclusions ETA acts on PFA expressed on keratinocytes in vitro,which is reversible along with withdrawal of ETA.The mechanism of E-TA act on PFA may be related to proteolytic action instead of promoting cytokine secretion.

Objective The purpose of this study is to investigate the expression of human epidermal growth factor receptor-2(HER-2)in gastric carcinoma tissue and normal gastric tissue of these patients,and its relationship with the clinical pathological characteristic,the microvessel density( MVD) and early post-operative recurrence,and to analyze the clinical significance of expression of HER-2 in gastric carcinoma,in order to lay the theoretical foundation of effective therapy for gastric carcinoma.Methods The clinical data of 398 cases of gastric cancer and 363 cases of their adjacent non tumorous gastric tissue of Liaoning Cancer Hospital from March 2012 to July 2013 were analyzed retrospectively.The expression of HER-2 gene was detected by IHC method and Fish method.The expressive rate of HER-2 in gastric carcinoma tissue and normal gastric tissue of these pa-tients were compared,and its relationship with the clinical pathological characteristic,MVD and early post opera-tive recurrence were also analyzed.Results (1)Expressive rate of HER-2 in 398 cases of gastric cancer tissue was 14.07%(56/398),which was higher than that in all the adjacent non tumorous gastric tissue presented none expression 0(0/363)(P<0.05);(2)In gastric cancer tissue of 398,the expression of HER-2 was related with Lauren type,tumor site,vessel invasion status,TNM stage,lymph node metastases(P<0.05),and it had no cor-relation with age,sex,tumor size,histological differentiation degree,growth patterns of cancer(P>0.05).Expres-sive rate of HER-2 in T4 stage was higher than( T1 +T2 +T3 ) stage,but the difference was not statistically sig-nificant( P>0.05).(3)The value of MVD in HER-2 expressive group(58.63 ±19.97)was significantly higher than those in HER-2 non expressive group(49.04 ±19.25).A positive significant correlation was found be-tween HER-2 and MVD expression using the rank correlation matrix(P<0.001,r=4.33).(4)1 year and 1.5 year of early post operative recurrence rate in HER-2 expressive group were 16.00%、38.00%,in HER-2 non expressive group were 8.81%,25.53%,the difference was not statistically significant(P>0.05).Conclusion There is excessive expression of HER -2 in gastric cancer tissue,excessive expression of HER -2 patients withgastric cancer is correlated with Lauren type,tumor location,vessel invasion status,TNM stage,lymph node metastases;it displays no correlation with age,sex,tumor size,histological differentiation degree,growth patterns ofcancer.HER -2 expression is positively associated with MVD value.Excessive expression of HER -2 is possibleto be correlative with early post operative recurrence,and it must have further follow up to confirm.

Objective To study the effect of acupuncture on the ratio of CD4+ CD25+ regulatory T cells and expression of transcription factor Foxp3 in patients with septic shock.Methods Sixty-four patients with septic shock were randomly divided into two groups by using the random number table method.Acupuncture group (34 cases) was treated with both western medicine and acupuncture,and control group(30 cases) was treated with western medicine.The period of treatment was 7 days.After treatment,the ratio of CD4+ CD25+ T cells in peripheral blood was determined by flow cytometry.And the expression of Foxp3 mRNA in peripheral blood was detected by quantitative real time PCR.Results After treating for 7 days,the ratios of CD4+ CD25+ Treg cells and CD4+ CD25+ Foxp3 + Treg cells were (20.23 ± 1.12) ％ and (78.70 ± 7.65) ％ respectively in peripheral blood of the control group,which in the acupuncture groupwere (17.32 ± 0.78) ％ and (68.53 ± 8.01) ％,the differences were statistically significant between the two groups(t =2.587,2.749,all P ＜ 0.05).The levels of Foxp3 mRNA in peripheral blood were (1.21 ±0.02) and (1.02 ± 0.04) in the control group and acupuncture group,the difference was statistically significant(t =2.119,P ＜ 0.05).Conclusion Acupuncture can adjust immune status of patients with septic shock by reducing the ratio of CD4+ CD25+ Treg cells and down-regulating the expression of Foxp3 mRNA.

Objective To investigate the clinical value of serum glycyl-proline dipeptidyl aminopeptidase(GPDA)combined with carcino-embryonic antigen (CEA),carbohydrate antigen724 (CA724),carbohydrate antigen242 (CA242) in the early diagnosis of gastric cancer.Methods Collected in Changan hospital in patients with gastric cancer and atrophic gastritis patients and healthy subjects 60 cases,by TBA-120FR biochemical analyzer glycyl-proline dipeptidyl aminopeptidase (GPDA),chemiluminescence analyzer to detect the levels of serum CEA,CA724 and CA242,analysis of single detection and joint detection and the differences between the positive rate and sensitivity.Results The detection of GPDA in gastric cancer group was significantly lower than that in atrophic gastritis group and healthy control group,the difference was statistically significant (F=69.532,P=0.000).The results of CEA,CA724 and CA242 in gastric cancer group were higher than those in atrophic gastritis group and healthy control group,the difference was statistically significant (CEA:F=59.926,P=0.001;CA724:F=51.056,P =0.001;CA242:F =72.613,P =0.000).Serum GPDA,CEA,CA724 and CA242 single detection positive rate were 70 ％,45 ％,61.7 ％ and 50 ％.Tumor markers CEA,CA724,CA242 positive rate of three joint detection was 75％.Serum GPDA and tumor markers of CEA,the positive rate of CA724 and CA242 combined detection of four was 86.7％.The positive rate of three and higher than that of single detection,the difference was statistically significant (F=49.635,P=0.003).Serum GPDA,CEA,CA724 and CA242 single detection sensitivity was 70.2 ％,50.2 ％,67.3 ％ and 53.2％.Tumor markers CEA,CA724,CA242 three joint detection sensitivity was 85.6％.Serum GPDA and tumor markers CEA,CA724 and CA242 four joint detection sensitivity was 90.3％.The sensitivity was higher than the three items and the individual tests,and the difference was statistically significant (F=52.016,P =0.001).Conclusion GPDA joint CEA,CA724 and CA242 tumor markers detection can improve the positive rate and sensitivity in early diagnosis of gastric cancer,but it will not reduce the diagnostic specificity,the clinical diagnosis of early gastric cancer has important significance and value.

Objective To sum up the magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) characters in patients with concentric sclerosis, and to investigate the association between imaging and possible pathogenesis.Methods Three patients with clinically diagnosed concentric sclerosis underwent MR] and DWI, one of whom was additionally performed 1H-magnetic resonance spectroscopy imaging (1H-MRS).Results Multiple lesions of laminated demyelination alternating with spared white matter were demonstrated in all 3 patients, and the enhanced lesions appeared to be concentric coils.Rings of alternating hypointense and hyperintense layers were shown on the DWI image, with apparent diffusion coefficient alternating correspondingly to the layers of the histologically demyetinated and undemyelinated areas.Conclusions Balo' s concentric sclerosis has unique characteristics on MRI and DWI, which corresponds to changes in its pathology and provides evidence for a better understanding of its pathophysiologic mechanisms.

Objective To explore the imaging characteristics of neurologic complications associated with the enterovirus 71 ( EV71 ) epidemic by analyzing 25 cases and reviewing the literature. Methods Twenty-five cases of hand-foot-mouth disease with neurologic complications during the recent EV71 outbreaks of Hainan province were studied for the clinical features and imaging findings, and literature were reviewed.Results In 5 cases, acute flaccid paralysis associated with EV71-infected hand-foot-mouth disease was related to the linear high signal in the spinal cord on sagittal images. Two cases showed symmetrical, welldefined hyperintense lesions in the spinal cord on T2WI transverse. Strong enhancement of the ventral horns and root was seen on the contrast-enhanced axial T1WI. In brainstem encephalitis, all lesions presented with significant hyperintensity on T2WI and hypointense on T1WI in the posterior portions of the medulla oblongata, midbrain, and pons. The manifestations of aseptic meningitis (AM) on MRI have no characteristics, but subdural effusion, meningeal enhancement and hydrocephalus can be the indirect signs of AM. Conclusions MRI is an effective method to investigate neurologic complications associated with the EV71 epidemic. Posterior portions of the medulla oblongata and pons, bilateral ventral horns of spinal involvement are characteristic findings of enteroviral encephalomyelitis.