Education, Nursing, Continuing ; General Surgery ; education ; Humans ; Physicians

BACKGROUND:Computer-assisted navigation technique has been widely applied in spinal surgery, but there is stil lack of systematic reviews on this technique in lumbar pedicle screw fixation.
OBJECTIVE:To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation.
METHODS:Databases such as PubMed, Embase and China journal ful-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as wel , and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared.
RESULTS AND CONCLUSION:Final y 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95%confidence interval (CI):(0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI:(-246.26,-98.53), P<0.000 01] had statistical y significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI:(-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI:(0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is stil needed to make clear whether this technique can improve final outcome in post-operative patients.

OBJECTIVE:To establish a method for determining the content of Ornidazole gel by first-order derivative spectrophotometry.METHODS:The first-order derivative spectrophotometry was used to determine the content of Ornidazole gel at a wavelength of 259nm and 299nm.RESULTS:The linear range of Ornidazole was 4.01～44.1?g?mL-1.The average recovery was 101.6%,with RSD of 1.3%.CONCLUSIONS:This method can meet the requirements for quality control of Ornidazole gel both in terms of precision and accuracy.

Dendritic Cell Sarcoma, Interdigitating ; Humans ; Lymph Nodes ; Male ; Middle Aged

Objective To study the effect of interventional treatment on the expression of PgP and GST ? in different histopathological types of primary lung carcinoma. Methods One hundred and eighteen cases of histopathologically verified primary lung carcinoma were studied. SCLC was found in 26 cases and NSCLC in 92 cases. The non chemotherapy group had 50 cases, and the interventional treatment group had 68 cases. PgP and GST ? were examined in all specimens with 2 step immunohistochemistry. Results The positive expression rates of PgP and GST ? were 32.0% and 34.0% in non chemotherapy group, respectively, 75.0% and 78.6% in interventional treatment with non embolization group, respectively, and 50.0% and 52.5% in interventional treatment with embolization group, respectively. The positive expression rates of PgP and GST ? had significant difference between non chemotherapy group and interventional treatment with non embolization group( P 0.05). There was a tendency of positive correlation between differentiated degree of carcinoma and the expression of PgP and GST ? in NSCLC. Condusion To detect PgP and GST ? in carcinoma tissue is important and has the instructive significance for chemotherapy of lung carcinoma. The positive rate of multidrug resistant gene is obviously increased in the primary lung carcinoma with bronchial arterial chemotherapy. The inducement to multidrug resistance gene in bronchial arterial embolization with the emulsifying agent of oil anticarcinogen was lower.

BackgroundWhether the peeling of the inner limiting membrane (ILMP) increase the closure rate of idiopathic macular hole is still in controversy.Some ophthalmologist recommend vitrectomy combined with inner limiting membrane peeling for the treatment of idiopathic macular hole.However,the removal of ILMP is difficult because of its similar appearance to adjacent tissues.Objective This study was to investigate the efficacy of triamcinolone acetonide(TA) and indocyanine green(ICG) double staining-assisted vitrectomy combined with ILM peeling during the surgery.Methods A consecutive case- observational study was designed.The standardized vitrectomy was performed in 25 eye of 23 cases with IMH.During the vitrectomy,TA and ICG were injected into posterior pole vitreous to visualize and assist the ILM peeling.The dying effectiveness was observed,and the closure rate of macular hole,visual acuity,intraocular pressure and complications were evaluated after surgery.Written informed consent was obtained from each patient prior to operation.Results Posterior vitreous cortex and ILM were visible and the residual vitreous and cortex were removed clearly after dying of TA and ICG in all the 25 eyes.During the following-up duration of 3-8 months,the completely anatomical reattachment of the macular area was in 22 eyes ( 88.0％ ) and partially reattachment in 3 eyes( 12.0％ ).The best corrected vision was 0.07-0.60 in all of the operated eyes 2 months after surgery.Conclusions TA and ICG- assisted vitrectomy combined with ILM peeling appears to be a safe and effective method for IMH repair.

Background:Traditional tissue engineering methods to fabricate urinary tract patch have some drawbacks such as compromised cell viability and uneven cell distribution within scaffold.In this study,we combined three-dimensional (3D) bioprinting and tissue engineering method to form a tissue-engineered urinary tract patch,which could be employed for the application on Beagles urinary tract defect mode to verify its effectiveness on urinary tract reconstruction.Methods:Human adipose-derived stem cells (hADSCs) were dropped into smooth muscle differentiation medium to generate induced microtissues (ID-MTs),flow cytometry was utilized to detect the positive percentage for CD44,CD105,CD45,and CD34 of hADSCs.Expression of vascular endothelial growth factor A (VEGFA) and tumor necrosis factor-stimulated gene-6 (TSG-6) in hADSCs and MTs were identified by Western blotting.Then the ID-MTs were employed for 3D bioprinting.The bioprinted structure was encapsulated by transplantation into the subcutaneous tissue of nude mice for 1 week.After retrieval of the encapsulated structure,hematoxylin and eosin and Masson's trichrome staining were performed to demonstrate the morphology and reveal collagen and smooth muscle fibers,integral optical density (IOD) and area of interest were calculated for further semiquantitative analysis.Immunofluorescent double staining of CD31 and a-smooth muscle actin (α-SMA) were used to reveal vascularization of the encapsulated structure.Immunohistochemistry was performed to evaluate the expression of interleukin-2 (IL-2),α-SMA,and smoothelin of the MTs in the implanted structure.Afterward,the encapsulated structure was seeded with human urothelial cells.Immunofluorescent staining of cytokeradns AE1/AE3 was applied to inspect the morphology of seeded encapsulated structure.Results:The semi-quantitative assay showed that the relative protein expression of VEGFA was 0.355 ± 0.038 in the hADSCs vs.0.649 ± 0.150 in the MTs (t--3.291,P =0.030),while TSG-6 expression was 0.492 ± 0.092 in the hADSCs vs.1.256 ± 0.401 in the MTs (t =3.216,P =0.032).The semi-quantitative analysis showed that the mean IOD of IL-2 in the MT group was 7.67 ± 1.26,while 12.6 ± 4.79 in the hADSCs group,but semi-quantitative analysis showed that there was no statistical significance in the difference between the two groups (t =1.724,P =0.16).The semi-quantitative analysis showed that IOD was 71.7 ± 14.2 in noninduced MTs (NI-MTs) vs.35.7 ± 11.4 in ID-MTs for collagen fibers (t =3.428,P =0.027) and 12.8 ± 1.9 in NI-MTs vs.30.6 ± 8.9 in ID-MTs for smooth muscle fibers (t=3.369,P=0.028);furthermore,the mean IOD was 0.0613 ±0.0172 in ID-MTs vs.0.0017 ± 0.0009 in NI-MTs for α-SMA (t =5.994,P =0.027),while 0.0355 ± 0.0128 in ID-MTs vs.0.0035 ± 0.0022 in NI-MTs for smoothelin (t=4.268,P =0.013),which indicate that 3D bioprinted structure containing ID-MTs could mimic the smooth muscle layer of native urinary tract.After encapsulation of the urinary tract patch for additional cell adhesion,urothelial cells were seeded onto the encapsulated structures,and a monolayer urothelial cell was observed.Conclusion:Through 3D bioprinting and tissue engineering methods,we provided a promising way to fabricate tissue-engineered urinary tract patch for further investigation.

Acinetobacter Infections ; etiology ; Acinetobacter baumannii ; drug effects ; isolation & purification ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Risk Factors

Objective To investigate whether recombinant human endostatin can create a time window of vascular normalization prior to vascular pruning to alleviate hypoxia in Lewis lung carcinoma in mice. Methods Kinetic changes in morphology of tumor vasculature in response to recombinant human endostatin were detected under a confocal microscope with immunofluorescent staining in Lewis lung carcinomas in mice. The hypoxic cell fraction of different time was assessed with immunohistochemical staining . Effects on tumor growth were monitored as indicated in the growth curve of tumors . Results Compared with the control group vascularity of the tumors was reduced over time by recombinant human endostatin treatment and significantly regressed for 9 days. During the treatment, pericyte coverage increased at day 3, increased markedly at day 5, and fell again at day 7. The vascular basement membrane was thin and closely associated with endothelial cells after recombinant human endostatin treatment, but appeared thickened, loosely associated with endothelial cells in control tumors. The decrease in hypoxic cell fraction at day 5 after treatment was also found. Tumor growth was not accelerated 5 days after recombinant human endostatin treatment. Conclusions Recombinant human endostatin can normalize tumor vasculature within day 3 to 7, leading to improved tumor oxygenation. The results provide important experimental basis for combining recombinant human endostatin with radiation therapy in human tumors.

Objective To evaluate the clinical efficacy and safety of kyphoplasty with single balloon cross-midline expansion using unipedicular approach for osteoporotic vertebral body compressive fracture (OVCF).Methods Thirty six cases of painful OVCF were included in the study,with 61 vertebrae involved.Under X-ray fluoroscopy monitoring,kyphoplasty was performed using a unilateral,single,balloon via a unilateral transpedicular approach.A final balloon position was in the midline of the vertebral body with the balloon cross-midline expansions and bone cement filled. Clinical outcomes were determined by comparison of preoperative and postoperative VAS and ODI scores.Radiographic assessment included vertebral height restoration and correction of kyphosis.Follow-up was conducted for 6.0-12.0 months(mean 9.2 months).Results Thirty-six consecutive patients with 61 vertebrae were successfully operated with an operative time of(37.4±9.6)rain per vertebra.All patients had significant pain relief and functional recovery within 96 h after the procedure with no surgery-and device-related complications.VAS score improved from(7.3±1.0)preoperatively to(2.7±0.8)postoperatively(t=19.53,P＜0.01).ODI score was decreased from(71.1±10.9)%preoperatively to(26.6±6.4)%postoperatively(t=18.54,P＜0.01).The average anterior body height loss was(14.3±2.8)mm before procedure and(10.0±1.8)mm after procedure(t=14.68,P＜0.01).The average middle body height loss was(10.2±2.7)mm before procedure and(5.9±1.8)mm after procedure(t=16.44,P＜0.01).The Cobb's angle was corrected from 23.4°±5.0° to 16.2°±2.8°(t=15.60,P＜0.01).Some leakages of cement around the anterior margin of vertebra and inter-vertebral space were found in 2 patients,but there were no clinical symptoms.X-ray examination indicated there were no cement leakages in other vertebra.The pain relief and functional recovery were substantial and maintained to the last follow up without any re-collapse or adjacent level fracture.Conclusions A single-balloon cross-midline expansion using unipedicular approach in kyphoplasty for OVCF is effective and safety,less operation time,less radiation exposure compared to the conventional kyphoplasty technique.