Objective To explore the normal number of lumbar lateral recess and the relationship between the CT pathology and clinical manifestation in the patients who suffered from lumbar lateral recess stenosis. Methods Lumbar specimen of 15 normal adult corpse and 20 healthy volunteers were observed, and the anterior and posterior(AP) sagittal diameters of normal lumber lateral recess were measured. The CT pathology and clinical manifestation of 174 patients who suffered from lumbar lateral recess stenosis were analysed. Results At the levels of L1 and L2, the lateral recess was found in about 34% normal persons.At the levels of L3 to S1, the lateral recess was found in all healthy persons.All patients who suffered from lumbar lateral recess stenosis had narrow AP sagittal diameters of lumbar lateral recess (

Peripheral blood mononuclear cells from 32 cases of osteosarcoma and 20 normal controls were separated and induced by lipopolysaccharide, followed by 48 hour incubation in vitro, then the supernatant were collected. The levels of IL-6 were measured by enzyme linked immunosorbent assays, the concentrations of NO were measured by Griess methods. The results were as follows: The concentrations of IL-6 and NO were significantly higher than those in normal contrls (P<0.01). There were positive correlation between the levels of IL-6 and NO in patients with osteosarcoma (r=0.652, P<0.01). The results suggest that the immune function of peripheral mononuclear cell in patients with osteosarcoma was disordered. It may activate peripheral mononuclear cells to produce high levels of IL-6 and NO, which may take part in the pathogenesis of osteosarcoma.

0.05).CONCLUSION:①There are not significantly changes of the stress in the inferior facet joint after ADR.②ADR will not add negative influence to the inferior facet joint when it rebuilds the biomechanical characteristics of lumbar spine.

Objective To investigate the beneficial effects of simvastatin on ventricular remodeling in rats after myocardial infarction and the possible mechanisms involved.Methods The myocardial infarction rat model was reproduced.Twenty-four hours after infarction,the survived rats were randomly divided into myocardial infarction group(MI group,n=9),simvastatin 10mg group [10mg/(kg?d),Sim1 group;n=8],simvastatin 20mg group [20mg/(kg?d),Sim2 group;n=10] and simvastatin 40mg group [40mg/(kg?d),Sim4 group;n=9].A sham-operated group(Sham group;n=10) served as control.Four weeks later,the serum lipid level,hemodynamic indexes and left ventricular weight index(LVWI) were measured.The changes in rats' myocardial tissue were observed with HE staining;the cross-sectional area of myocardial cells was calculated.The expressions of transforming growth factor ?1(TGF-?1) and TGF-?-activated kinase 1(TAK1) in non-infarction area were determined by Western blotting and reverse transcription polymerase chain reaction(RT-PCR).Results The hemodynamic indexes,LVWI,cross-sectional area of myocardial cells and the pathological changes were improved,and mRNA and protein expressions of TGF-?1 and TAK1 were down-regulated significantly in the 3 Sim-treated groups compared with that in MI group.The indices mentioned above were significantly different in Sim2 and Sim4 group compared with Sim4 group(P0.05).Conclusion The inhibitory effect of simvastatin on ventricular remodeling after acute myocardial infarction is independent of its lipid-regulating effect,but possibly attributed to its action in inhibiting the TGF-?1/AK1 signal transduction.Within the concentration of 20mg/(kg?d),the therapeutic efficacy of simvastatin may be more obvious with an increase in its dosage.

BACKGROUND: Previous studies demonstrate that interleukin 1β(IL-1β) plays a great role in the degeneration of articular cartilage in knee joints which was caused by the anterior cruciate lagement (ACL) rupture; however, the role of IL-1β in the degeneration of lateral meniscus remains poorly understood. OBJECTIVE: To investigate the changes and significance of the expression of IL-1βin the lateral meniscus of rabbits with ACL rupture. METHODS: A total of 48 male, New Zealand, white rabbits, were matched mode pairs and prepared for ACL rupture models. In the experimental side, the ateral meniscus of rabbits was cut down to prepare ACL rupture models, simultaneously, the control sides were exposed without cut down. A total of 12 rabbits were secdficed under anesthesia at weeks 1, 3, 6 and 8 after model preparation. Degeneration scores of lateral meniscus and expression of IL-1β in lateral meniscus were performed. RESULTS AND CONCLUSION: With time prolonged, the scores of lateral meniscus degeneration were increased, which was higher in the experimental group than those in the control group at each time points (P < 0.05). The positive rate of IL-1β was greater in experimental group than that in the control group (P < 0.05). In addition, the positive rate of IL-1β in the experimental group was greater at weeks 3 and 6 than weeks 1 and 8 (P < 0.05), which was higher in week 8 than week 1 (P < 0.05). The results demonstrated that the highly expressed IL-1β in the experimental sides hints that IL-1β maybe a promotional factor which causes the degeneration of lateral meniscus. The decreasing of the expression of IL-1β is not a stopping signs of lateral meniscus degeneration.

0.05).Compared with those in Sham group,LVWI,the typeⅠCVF,type Ⅲ CVF andⅠ/Ⅲ ratio in NIZ were increased significantly in MI group.Compared with those in MI group,the LVWI,the type ⅠCVF,type Ⅲ CVF andⅠ/Ⅲ ratio in NIZ were decreased significantly in Sim groups(but higher than those in Sham group).Compared with MI groups,left ventricular function in rats treated with simvastatin was also obviously improved.(2) Contrasted to those in MI group,the expressions of TGF-?1 and Smad3 were down-regulated in simvastatin treatment groups(but higher than those in Sham group).Conclusions Sim can ameliorate ventricular remodeling and ventricular function in rats induced by MI,and the mechanisms can be independent of its lipid-lowering and associated with inhibition of TGF-?1/Smad3 signal transduction.

OBJECTIVE: To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs). METHODS: The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed. RESULTS: Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved (<0.05), and there was no significant difference between 3 d and half a year after operation (>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up. CONCLUSION VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.
Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures ; Retrospective Studies ; Spinal Fractures ; Stents ; Treatment Outcome ; Zoledronic Acid

Objective: To investigate the relationship between the mechanical circulatory support (MCS) combined with immunomodulation and the prognosis of patients with fulminant myocarditis. Methods: This is a retrospective study. A total of 88 patients with fulminant myocarditis admitted to Dongguan Kanghua hospital from Aug. 2008 to Dec. 2020 were included. Medical histories, results of laboratory tests, treatment regimens and clinical outcomes of these patients during their hospitalization were collected from the medical record system. According to the treatment methods, the patients were divided into MCS+immunomodulation group (38 cases), MCS group (20 cases) and traditional treatment group (30 cases). Patients in the MCS+immunomodulation group received intra-aortic balloon pump (IABP) or IABP combined with extracorporeal membrane oxygenation (ECMO) and immunoglobulin or glucocorticoid. Patients in the MCS group only received mechanical circulatory support. Patients in the traditional treatment group received neither mechanical circulatory support nor immunomodulatory therapy, and only used vasoactive drugs and cardiotonic drugs. The in-hospital mortality and length of stay were compared among the three groups. Results: A total of 88 patients with fulminant myocarditis aged (35.0±10.8) years were included, and there were 46 males (52.3%). The mortality of MCS+immunomodulation group (7.9% (3/38) vs. 56.7% (17/30), P=0.001 2) and MCS group (30.0% (6/20) vs. 56.7% (17/30), P=0.002 8) were lower than that of traditional treatment group. Compared with the MCS group, the in-hospital mortality in the MCS+immunomodulation group was lower (P=0.005 4). The most common cause of death was multiple organ dysfunction syndrome (MODS). The constituent ratios of death in MCS+immunomodulation group, MCS group and traditional treatment group were 3/3, 4/6 and 12/17, respectively. The incidence of MODS in the MCS group (20% (4/20)) and the traditional treatment group (40% (12/30)) was significantly higher than that in the MCS+immunomodulation group (7.9% (3/38)) (both P<0.01). In discharged patients, the hospitalization time of MCS+immunomodulation group was shorter than that of traditional treatment group ((13.4±5.5)d vs. (18.5±7.4)d, P<0.05) and MCS group ((13.4±5.5)d vs. (16.9±8.5)d, P<0.05). Conclusion: MCS combined with immunomodulatory therapy is associated with lower in-hospital mortality and shorter hospital stay in patients with fulminant myocarditis.
Adult ; Heart-Assist Devices ; Humans ; Immunomodulation ; Male ; Middle Aged ; Myocarditis/therapy* ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective: To explore the postoperative effect, prognosis, and prognostic factors for benign testicular tumors. Methods: We retrospectively analyzed the clinical data of 35 patients with benign testicular tumors between May 2004 and May 2017 from Sun Yat-sen University Cancer Center, and the patients were followed up until October 2017. Results: The mean age of the 35 patients was 18.8 (0.4-44.0) years. Among them, 14 patients (40.0%) underwent testis-sparing surgery and 21 (60.0%) underwent radical orchiecto-my, and the tumor sizes were 1.8 (0.4-4.0) cm and 2.7 (1.0-8.0) cm, respectively. All patients had been cured without obvious perioper-ative complications. Postoperative histopathological tumor types included 18 epidermal cysts, 10 mature teratomas, 4 interstitial cell tumors, and 3 adenomatoid tumors. Frozen section examination of 10 cases had been operated, and all results were consistent with paraffin pathology. No patient who underwent testis-sparing surgery showed recurrence and/or metastasis during follow-up, and their sexual function and fertility were well preserved. Conclusions: Testis-sparing surgery is reliable, and the size of the tumor determines its implementation. An intraoperative rapid frozen section examination should be performed in patients with testicular neoplasms of a benign or variable nature diagnosed before operation. Patients with benign testicular tumors should undergo testis-sparing surgery, whereas others should undergo radical orchiectomy.

Objective: To explore the clinical effects and key techniques of expanded super-thin perforator flaps in the shoulder, neck, and chest in reconstruction of extensive burn scars in the face. Methods: From January 2008 to November 2018, 22 patients with extensive burn scars in the face were admitted to the Department of Plastic Surgery of Dongguan Kanghua Hospital and the Department of Plastic Surgery of Dermatology Hospital of Southern Medical University, with 3 males and 19 females, aged from 4 to 48 years. There were 16 cases of type Ⅱ and 6 cases of type Ⅲ in facial scars. Before the first stage of expansion surgery, Doppler blood flow survey meter or multi-slice CT was used to locate the perforator vessels. One to four expanders with rated capacity ranged from 100 to 600 mL were placed in the patients. We gave 20% to 30% of the rated capacity of expander intro-operation and common injection with 10% to 15% of the rated capacity of expander per week post-operation until the volume reached 1.5 to 2.5 times of the rated capacity of expander during the past 3 to 4 months. At the second stage of surgery, the perforators were located again before surgery with the same method. The size of defects after the excision of facial scars ranged from 6 cm×4 cm to 18 cm×16 cm. With perforators used as nutrient vessels, narrow pedicle flaps or random flaps ranging from 6 cm×6 cm to 22 cm×18 cm were elevated as rotating or advancing to reconstruct the defects. The donor sites were sutured directly. Some of the flaps needed stage Ⅲ operation for cutting the pedicle. The survival of flaps, post-operation complications, and follow-up were assessed. Results: All flaps of 22 patients survived. All the donor sites were closed simultaneously. One patient underwent an additional surgery for 5 cm×4 cm necrosis on distal part of flap caused by subcutaneous hematoma. Two patients with epidermis blister on the flaps were healed by themselves after dressing change. Due to rapid expansion, blood capillary proliferation appeared on the central part of the flap in 3 cases, after slowing down the expansion speed properly, which had no impact on flap transfer. No ischemia or venous congestion phenomenon were observed in the other flaps. During follow-up of 5 to 48 months, the flaps of patients showed no significant bloated appearance, with good complexion and texture, and even could reproduce facial fine-grained expressions naturally. Conclusions For the reconstruction of extensive burn scars in the face, expanded super-thin perforator flaps can not only acquire large and thin flaps with high matching degree surface skin defect, but also reproduce facial fine-grained expressions. It is a simple and safe method which conforms to the facial aesthetic standard.