Objective To evaluate the chnical effect of posterior decompression and shortsegment pedicle instrumentation treating for thoracolumbar fracture with neurologic deficits in different time intervals.Methods Seventy-nine cases of thoracolumbar fracture with neurologic deficits were treated with shortsegment pedicle instrumentation combined with decompression according to the injury and surgery patients with injury of different time interval were divided into ≤24 h group (41 cases) and ＞ 24 h group (38 cases),the curative effect was evaluated by imaging and nerve function recovery.Results Postoperative hospital stay were performed X-ray check,10-14 d after hospital discharge,were primary healing of incision.A total of 79 patients with thoracolumbar fracture combined with neurologic deficits were followed up for 23.5 (15-32) months averagely.Did not appear in the source sex procedure for postoperative infection,nerve injury and postoperative spinal cord injury aggravated phenomenon,not implants rupture,bending and screw loose phenomenon.There was significant difference at 3 d postoperative and the last follow-up in the rate of vertebral compression,cobb' s angle and spinal canal stenosis rate in two groups [≤ 24 h group:(7.9 ± 4.2)％,(8.5 ± 5.0)％ vs.(40.8 ± 8.4)％ and (3.9 ± 2.5)°,(4.2 ± 2.6)° vs.(28.1 ± 13.1)° ; ＞ 24 h group:(8.8 ± 4.8)％,(9.2 ± 4.8)％ vs.(41.7 ± 7.6)％ and (5.3 ± 2.6)°,(5.7 ± 2.7)° vs.(27.6 ± 12.1)°] (P ＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).The stenosis rate in two groups at 3 d postoperative was obviously better than preoperative[≤24 h group:(5.3 ± 1.5)％ vs.(41.4 ± 6.1)％; ＞ 24 h group:(6.8 ± 1.1)％ vs.(40.5 ± 5.4)％] (P ＜ 0.05),and ≤ 24 h group was superior to ＞ 24 h group,there was significant difference (P ＜ 0.05).At the last follow-up,the neurological function with ASIA grade 1-2 level recovery,≤24 h group mean improved 1.4 level,and ＞ 24 h group mean improved 1.2 level.Conclusion The opertion of pedicle instrumentation combined with decompression with nerve function damage can rebuild spinal stability,favorable neural functional recovery.

Objective To determine ursolic acid in Shanzhajing Jiangzhi Tablets by HPLC method. Method Chromatographic column was Kromasil C18 (4.6 mm?200 mm, 5 ?m). The Mobile phase was methanol- 0.15% phosphoric acid (88∶12), and the flow rate was 1.0 mL/min. Detection wavelength was 215 nm. Column temperature was room temperature. Results Ursolic acid quantity and its peak area showed good linearity relationship in the range of 0.253～5.052 ?g. The correlation coefficient (r ) was 0.9998 (n=6). The average recovery was 100.37% and RSD was 1.88%. Conclusion The method is easy and accurate, with good sensitivity and repeatability. It is a good method to control the quality of Shanzhajing Jiangzhi Tablets.

Objective To investigate the reasons of complications after ultrasound-guided PTBD and explore measures for their management. Methods The clinical data of 753 patients with obstructive jaundice treated with ultrasound-guided PTBD in our hospital from January 2001 to June 2008were retrospectively analyzed. Results The 753 patients received a total of 791 treatments of PTBD.The occurring rates of severe, common, and long-term complications were 1.14 % (9/791), 11.88 %(94/791 ) and 4.3% (9/791), respectively. Only 1 patient died of manipulation-related complications.Conclusion Ultrasound-guided PTBD is an effective method for treatment of obstructive jaundice.

Objective To investigate the effects of soluble components derived from bone marrow mesenchymal stem cells (BMSCs) on the expression of vascular endothelial growth factor (VEGF) and liver regeneration caused by 70％ portal branch ligation (PBL) in rats.Methods Isolated and cultured BMSCs were lysed by sonication.PBL was performed in male SD rats followed by splenic injection of BMSCs or PBS as control.Animals were analyzed for liver regeneration index,hepatocytes proliferation,hepatic function,histopathological changes,and hepatic genes expression.Expression of VEGF was assessed by Western blot and immunohistochemistry.Results The liver regeneration index increased in the BMSCs group especially 2 and 5 days after PBL compared with the control group (P＜0.05) and reached (51.71±1.62)％ and (76.82±0.81)％ respectively.A 2-fold increase was showed in the PCNA labeling index of hepatocytes in rats treated with BMSCs compared with the control group (P＜0.05).Histopathological findings showed that vacuolar change and sinusoidal congestion were lower in the BMSCs group.Alanine transaminase (ALT) and Aspartate transferase (AST) showed no significant difference between the two groups (P＞0.05).On post operation day 2,hepatic interleukin-6 (IL6),tumor necrosis factor α (TNFα),hepatocyte growth factor (HGF),vascular endothelial growth factor A (VEGFA),and vascular endothelial growth factor 2 (VEGFR2) mRNAs tended to increase in the BMSCs group (P＜0.05) while transforming growth factor β1 (TGFβ1) mRNA decreased (P＜0.05).Western blot showed that the expression level of VEGF in the two groups were equal 2 and 5 days after surgery (P＞0.05).On day 2 post operation,positive VEGF immunoreactivity was present in both pericentral and periportal hepatocytes in the BMSCs group,while only in periportal hepatocytes in the control group.Conclusion These results demonstrate that BMSCs accelerated liver regeneration caused by PBL,which may result from hepatoprotection,enhanced hepatocyte proliferation,and VEGF-mediated angiogenesis early after the operation,potentially creating a new avenue for the study of hepatic regeneration.

Remarkable progress has been achieved in the transplantation of mesenchymal stem cells (MSCs)for the treatment of liver injury and hepatic failure.However,there are obstacles such as low engraftment capacity,tumorigenesis,and a fibrogenic potential that all hamper the use of MSCs in clinical trials.Therefore,it is worthwhile to talk about the alternatives that will increase the safety and efficacy of MSCs therapy.To date,applications of MSCs-derived hepatocytes,genetically modified MSCs,or MSC-conditioned medium for promoting liver regeneration have shown encouraging results.This review summarizes the current applications of MSCs in the study of hepatic regeneration.

Objective To optimize supercritical extraction technique from four medicinal materials, which are the part components in the recipe of Keganliyan Oral Liquor and are extracted traditionally for essential oils. Methods Extraction ratio and menthol extraction quantity were taken as evaluated indexes. Supercritical extraction technique was researched with orthogonal tests, gas chromatography, and SAS statistic. Results Within the test levels, temperature and time showed evident effect on extraction ratio and menthol extraction quantity, while pressure did not show any evident effect on them、 The preferable technique to extraction ratio is temperature at 55 ℃, time for 120 min, and extracted pressure at 27 MPa; and the preferable technique to menthol extraction quantity is temperature at 45 ℃, time for 120 min, and extracted pressure at 22 MPa. Conclusion The optimized supercritical extraction technique for Keganliyan Oral Liquor is feasible.

Objective:To evaluate the preventive effect of Danshen Shuizi Capsule on vascular restenosis after stent implantation.Methods:48 patients with endovascular stent implantation were randomly assigned to control group(n=25) (treated with western medicines)and treatment group(n=23)(treated with Danshen Shuizi Capsule)after endovascular stenting implantation.The intraluminal diameter of stenting segment was measured by QCA at 6 months after stent implantation.Results: The diameter of reference vessel in two groups was not significantly different.The intraluminal diameter of stent segment in the treatment group was not larger than that in the control group(2.22?0.21)mm vs(2.18?0.25)mm.The index number of vessel diameter reduction in treatment group was not less than that in the control group(0.50?0.16)mm vs(0.51?0.11)mm.The rate of restenosis(18.4%)and reintervention(13.1%)in treatment group were not lower than those in the control(20%,12%).However,the complication in treatment group was significantly lower than that in control group.Conclusion:These findings indicated that endovascular was useful for the prevention of endovascular restenosis after stent implantation with fewer complications

Objective To explore the thoracic and diaphragmatic complications of treating hepatic malignant tumor using thermal ablation techniques.Methods The patients received thermal ablations were involved as subjects from January 2002 to December 2013.The thoracic and diaphragmatic complications of treating hepatic malignant tumor with percutaneous thermal ablation were retrospectively analyzed.Results A total of 1 520 patients with 2 789 hepatic tumors [average largest diameter of tumor (2.30 ± 1 .03)cm] underwent 2 066 thermal ablation treatments.Five hundred and six radiofrequency ablation (RFA)and 1 560 microwave ablation procedures were performed,respectively.The complete ablation rate was 96.8%(2 701/2 789)at 1 month after treatment.The major thoracic and diaphragmatic complication rates were 0.8%(1 7/2 066 ),meanwhile the minor complication rates were 6.5% (134/2 066 ).Conclusions The thoracic and diaphragmatic complication rate of percutaneous thermal ablation is low in the treatment of hepatic malignant tumors.However,the major complications may cause serious consequences.Therefore, the patients of diaphragm-abutting liver tumors are fully assessed before thermal ablation treatments,and relevant prevention measures are completed.Open or laparoscope is used to assist thermal ablation treatment when necessary.

Objective To compare the diagnostic value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced helical computed tomography (CECT) for hepatocellular carcinoma (HCC) with liver cirrhosis. Methods Two hundreds and forty-one focal liver lesions in 207 patients with Hepatitis B virus (HBV) cirrhosis were detected with CEUS and CECT, respectively. Pathological results were used asgold standardto compare the two methods. Diagnostic results of the two methods were compared with pathological results. Differences were assessed using the McNemar test, and the Kappa test was used for consistency evaluation. Results (1) For 113 liver lesions that were ≤2 cm, the number of HCC lesions was 63, and the number of benign lesions was 50. There were no significant differences in results of CEUS and CECT compared with that of the gold standard of McNemar test results (P = 0.824, P = 0.082). Consistency of the Kappa test results of CEUS and CECT in comparison with the gold standard was general (Kappa = 0.643, Kappa = 0.421). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HCC diagnosed by CEUS were higher than those of CECT. The rate of arterial enhancement was better for CEUS [87.30% (55/63)] than that for CECT [69.84%(44/63),χ2=5.704, P=0.017]. (2) For 128 liver lesions that were>2 cm, the number of HCC lesions was 77, and the number of benign lesions was 51. There were no significant differences in the diagnostic results between McNemar test and CEUS and CECT tests (P = 0.481, P = 0.167). Consistency of the Kappa test results of CEUS and CECT and gold standard was general (Kappa = 0.710, Kappa = 0.697). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HCC were not different between two diagnostic methods. The rate of arterial enhancement was 89.61%(69/77) for CEUS and 85.71%(66/77) for CECT, and there was no significant difference between the two groups (χ2=0.540, P=0.462). Conclusion For HCC≤2 cm, the diagnostic performance of CEUS is better than that of CECT. For HCC>2 cm, the diagnostic performance is similar for the two diagnostic methods.

Objective To analyze the application of quality control cycle (QCC) in reducing the false negative rate of minimal residual disease (MRD) of flow cytometry in patients with acute myeloid leukemia (AML). Methods In AML patients with abnormal fusion gene detected in hematology laboratory of Changhai Hospital during the year of 2014, the prevalence of AML-MRD detected both by flow cytometry (FCM) and real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) were analyzed retrospectively. The possible causes of false negative rate of flow cytometric MRD referring to PCR were further deeply analyzed, and the improvement measures were adapted from January 2015 to December 2015 and further judged all according to the QCC methods. Results Pareto diagram showed that the dilution and coagulation of the specimen, the improper analysis strategy and the incomplete combination of the MRD index [composition ratio:83.3 % (60/72)] were the main factors leading to the leakage of FCM MRD in 2014. The QCC group devised measures to reduce the dilution probability of bone marrow and develop a standard operating procedures (SOP) for sampling and testing, strengthen the maintenance of the flow instrument and more importantly, focused on optimizing the antibody panels and gated strategies referring to the current two main kinds of MRD detection combination modes on the basis of the latest advances published in 2015. Finally, the undetected rate of AML-MRD was reduced by FCM from 14.8 % (72/486) in 2014 to 2.6 % (16/620) in 2015. Conclusions The QCC can effectively reduce the leakage rate of flow cytometric AML MRD, improve the ability of laboratory quality control and the ability to solve problems. Solving problems with QCC is thus worthy of being popularized.