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 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.

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

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.

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 study the inhibitory effects of δ-opioid receptor activation in serumdeprivation induced apoptosis of human liver cells and the proposed protein kinase C(PKC)pathway mechanism.Methods MTT assay was used to detect the survival rate of human liver cells in vitro and Annexin V-FITC/PI double staining was used to detect the cell apoptosis rate.Flow cytometry was used to analyze cell cycle,RT PCR used to analyze the PKC mRNA and Western Blot analysis was used for detecting the protein expression of PKC and Caspase-3.Results After serum-deprivation for 48h of cultured human liver cells in vitro,significant liver cell apoptosis occurred.The apoptosis was suppressed by δ-opioid receptor activation,which manifested as a slower rate of apoptosis,decreased expression of Caspase-3and increased expression of PKC.After GF109203X was added,the inhibitory effects of DADLE decreased markedly.Conclusion Activation of δ-opioid receptor on the membrane of human liver cells has inhibitory effects on serum-deprivation induced apoptosis of liver cells.The underlying mechanism may be associated with PKC pathway activation.

BACKGROUND: In kyphoplasty procedure, two balloons are inserted into the vertebral body and inflated simultaneously for height symmetric restoration of the vertebral body. However, the expensive cost of balloon of kyphoplasty limits the extensive development of this procedure in developing countries. In this study, we try to inflate single balloon with bilateral transpedicular routes alternatively to achieve vertebral body height balanced restoration and reduce operation expenditure. But biocompatibility of bone cement and effect of kyphoplasty still need further observation.OBJECTIVE: To investigate the biocompatibility of bone cement and the clinical efficacy of bipedicular kyphoplasty for osteoporotic vertebral compression fractures by inserting single inflatable balloon into injured vertebral body and filling bone cement in the cavity caused by inflating balloon via bipedicular approach.DESIGN: Controlled observation.SETTING: Department of Medical Imaging, General Hospital of Jinan Military Area Command of Chinese PLA.PARTICIPANTS: Twenty-two patients (31 vertebral bodies) undergoing kyphoplasty with single balloon in Department of Medical Imaging, General Hospital of Ji'nan Military Area Command of Chinese PLA from May 2004 to May 2005 were selected, including 5 males and 17 females aged 68-85 years. Patients with painful compression fractures caused by osteoporosis were enrolled, and confirmed by CT and MRI with complete vertebral posterior wall but no spine deformity. The informed consent was obtained from all subjects, and the experiment and treatment were approved by Ethics Committee. METHODS: The especial instrument for kyphoplasty including puncturing device and balloon were provided by Shandong Guanlong Medical Utensils Co., Ltd. [LDAI (T) 2004 No. 2150017]; bone cement (Polymethymethacrylate) was made in China [MAIT 2005(T) No. 3650267]. Under X-ray fluoroscopy monitoring, single inflatable balloon was inserted into fractured vertebral body by puncturing needle and inflated via bipedicular approach to restore vertebral height. MAIN OUTCOME MEASURES: ①Bone cement biocompatibility during and after surgery; ②pain relief within 72 hours after surgery, restoration of vertebral height and correction of kyphotic deformity.RESULTS: ①Bone cement biocompatibility: Little cement leakage was observed at one intervertebral space of one patient by X-ray film, but no clinical symptoms, inflammatory reaction or rejection were found. ②Obvious pain relief was found in 22 cases with within 72 hours after kyphoplasty. ③The height loss of the anterior and middle vertebral body reduced from (14.70±4.21) mm and (10.62±4.11) mm preoperatively to (10.38±4.23) mm and (6.45±4.04) mm postoperatively after single balloon inflation and cement filling. Cobb angle was corrected averagely from (21.15±6.33)° preoperatively to (11.64±4.33)° postoperatively. CONCLUSION:Biocompatibility of bone cement is good, and no specific adverse effects are found in despite of cement leakage. Bipedicular kyphoplasty with single balloon for painful osteoporotic vertebral compression fractures effectively restores vertebral heights and relieves pain.