Objective To explore the clinical effect about the treatment of intrasacrospinal muscular approach and midline approach in lumbar interbody fixation with fusion for lumbar spinal stenosis.Methods Forty-two cases lumbar spinal stenosis were reviewed retrospectively in Meitan General Hospital from February 2009 to February 2014.All cases were divided into intrasacrospinal muscular approach and midline approach group(Group A,n =19) and midline approach group(Group B,n =23) according to the different surgical approach.Operation time,the amount of blood loss,post-operative drainage were compared.The VAS score of low back pain and leg pain preoperative and 6 months after operation were recorded.All cases were followed up for more than one year to evaluate fusion status.Results All cases were followed up for 13.0-20.0 months,with an average of (16.0± 1.2) months,all patients had bony fusion.Operation time,the amount of blood loss,postoperative drainage of Group A were significantly less than of Group B,the differences were significant ((95.1±4.5) min vs.(110.4±6.6) min,(75.2±5.1) ml vs.(159.8±7.2) ml,(53.6±4.3) ml vs.(86.2±14.1) ml;t =1.565,6.087,2.371;P＜0.05).VAS of back pain and leg pain at 6 months after operation of Group A showed better results than of Group B,the differences were significant((1.43±0.76) points vs.(1.39±1.00) points,(2.78± 1.23) points vs.(2.52±0.88) points;t =1.982,1.774;P＜0.05).Interbody fusion was obtained in two groups at the end of the last follow-up.Conclusion The intrasacrospinal muscular approach and midline approach for lumbar interbody fixation with fusion for lumbar spinal stenosis is better in less injury to paraspinal muscle,less blood loss and less post-operative drainage,which contributes a rapid recovery.

Objective:To investigate the anti-proliferation and anti-metastasis effects and study the molecular mechanism of sinomenine in cell line(HepG2).Methods: HepG2 cells were cultured together with different treatment concentrations of sinomen-ine.The effect of sinomenine on inhibition of growth of HepG2 cells were determined by methyl thiazolyl tetrazolium(MTT) assay.The effect of sinomenine on inhibiting metastasis of HepG2 cells were determined by Transwell assay.The inhibitory effect of sinomenine on reverse transcriptase(RT) was studied using inhibitory kinetic method,on the basis,the reactive oxygen species(ROS) of HepG2 cells was monitored by indirect fluorescent labeling.The protein expressions of CASP3,CASP9,CAV1 and SOX2 were analyzed by Western blot experiment.Results: Sinomenine inhibited the proliferation and metastasis of HepG2 cells significantly.Sinomenine had a good inhibitory effect on the growth of HepG2 cells,half inhibitory concentration(IC50) was (15.35±2.43)μmol/L.Sinomenine was RT inhibitor,IC50 was (21.32±2.43)μmol/L.The Western blot showed that CASP3,CASP9 and CAV1 were up-regulated and SOX2 was down-regulated by the sinomenine treatment in HepG2 cells.Conclusion: The potential molecular mechanism of sinomenine suppresses proliferation and metastasis of HepG2 cells by up-regulation of CASP3,CASP9,CAV1 and down-regulation of SOX2.

Objective To Study on the immune function of Cedar pollinosis.Methods The radioimmunosorbent test was used to measure IgE and the nephelometry was used to measure serum IgG,IgM,IgA,C3 and C4 levels.Results Total IgE leve in the patients serum was obviously higher than that in the control group,the serum IgG,IgM levels were also higher than those of control group,but the IgA level was no evident difference between two groups,and the serum C3 and C4 levels were lower than that of the control group.Conclusion Combination of a rising serum IE,IgG,IgM and a decreasing serum C3,C4 levels may be a diagnostic marker of cedar pollinosis,periodical determination of immune function for patients with cedar pollinosis could dynamic observe the change of the patients' condition.

Objective To investigate the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.Methods The clinical data of 450 cases of patients who received laparoscopic inguinal hernia repair by the same group of surgeons from December 2012 to August 2016 in our hospital were sequentially divided into three groups,with 150 cases in each group.The cases of each group who received TEP inguinal hernia repair were extracted and enrolled into group A,B and C.The preoperative,intraoperative and postoperative indicators were compared among the three groups.Results Before operation,no statistically significant difference was found in age,gender,incidence rates of scrotum hernia,recurrent hernia and bilateral hernia,and types of hernia among the three groups (P＞0.05).And there was no statistically significant difference in incidence rates of postoperative urinary retention,analgesia and seromas,and hospitalization expenses among the three groups (P＞0.05).During operation,differences in conversion rate,operative time and volume of blood loss among the three groups were statistically significant (P＜0.05).Moreover,statistically significant differences in conversion rate,operative time and volume of blood loss were found between group A and group B (P＜0.05),while there was no statistically significant difference between group B and group C (P＞0.05).The regression curves were drawn based on operation time,volume of blood loss and the number of cases,which estimated the inflection point was 150.Conclusion The learning curve of TEP inguinal hernia repair include approximately 150 cases of laparoscopic inguinal hernia repair (including 16 cases of patients received TEP).The TEP inguinal hernia repair operation during the learning curve can be safety on the basis of preoperative evaluation and appropriate case selection.

Objective To investigate influencing factors of the number of lymph node harvest after radical resection of colorectal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 227 patients with colorectal cancer who underwent radical resection in People's Hospital of Changshou Chongqing from June 2010 to June 2016 were collected.The surgical method and resection extention were determined depending on the tumor location showed on imaging examinations,and all patients underwent radical resection and sufficient lymph nodes dissection.Observation indicators:(1) intra-and post-operative situations;(2) influencing factors analysis of the number of lymph nodes harvest after radical resection of colorectal cancer;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to October 2016.Measurement data with normal distribution were represented as (x)±s.Univariate analysis was done using the chi-square test or Fisher exact probability method.Multivariate analysis was performed using the binomial Logistic regression analysis.Results (1) Intra-and postoperative situation:all the 227 patients underwent successful radical resection of colorectal cancer,including 67 with radical resection of right colon cancer,16 with radical resection of left colon cancer,26 with radical resection of sigmoid colon cancer and 118 with radical resection of rectal cancer.Of 227 patients,118 received laparoscopic surgery,109 received open surgery including 8 converted to open surgery from laparoscopic surgery.Tumor located in right hernicolon,left hemicolon,sigmoid colon and rectum were respectively detected in 67,16,26 and 118 patients,same as results of imaging examintions.Operation time,volume of intraoperative blood loss and number of lymph nodes harvest in 227 patients were (192 ± 72) minutes,(94± 84) mL and 14 ± 4.Of 8 patients in 227patients with postoperative complications,2 received secondary suture due to wound infection,2 received reoperation due to intestinal obstruction,1 received transverse colostomy due to anastomotic leakage,and 3 received stoma reconstruction due to stoma retraction.Duration of postoperative hospital stay of 227 patients was (22±9) days.Postoperative pathological examininations:35 and 192 patients were respectively diagnosed with rnucinous adenocarcinoma and non-mucinous adenocarcinoma.Moderate-and low-differentiated carcinoma and high-differentiated carcinoma were respectively detected in 47 and 180 patients.(2) The influencing factors analysis of the number of lymph nodes harvest after radical resection of colorectal cancer:univariate analysis showed that tumor location and tumor pathological T stage were related factors affecting the number of lymph node harvest after radical resection of colorectal cancer (x2=10.066,P＜0.05).Multivariate analysis showed the tumor location and tumor pathological T stage were independent factors affecting the number of lymph nodes harvest after radical resection of colorectal caucer (OR=1.283,6.075,95％ confidence interval:1.031-1.597,1.215-30.385,P＜0.05).(3) Follow-up and survival situations:190 of the 227 patients were followed up for 4-72 months,with a median time of 32 months.During the follow-up,21 patients died,23 patients survived with tumor,and 146 patients survived without disease.Conclusion Tumor location and tumor pathological T stage are independent factors affecting the number of lymph node harvest after radical resection of colorectal cancer.

Objective To study the morphological characteristics of blood-tumor barrier(BTB)model of glioma in vitro. Methods After C 6 glioma cells/endothelia ECV 304 co-cultured mixed or in Transwell or on both sides of membrane of Transwell,the morphological characters of fenestra of endothelial cells,the junction between ECV 304 cells,the interface between C 6 cells and ECV 304 cells,and perivascular-end-feet of C 6 cells were observed under transmission electron microscope(TEM)and scanning electron microscope(SEM),and compared to BTB in 4 cases with human brain glioma. Results ECV 304 cells grown to confluence were not fenestrated,but with fomation of tight junction between ECV 304 cells after co-cultured with C 6 cells mixedly,in Transwell or on both sides of membrane of Transwell;It was not found that pseudopodia from C 6 cells as co-cultured in Transwell reaching into pore of Transwell;C 6 cells co-cultured on both sides of membrane of Transwell often sticked out to the ECV 304 cells,but with no pseudopodia from C 6 cells surrounded ECV 304 cells of penetrated the endothelia clefts.Perivascular-end-feet of C 6 cells were not integrant.These characters were similar to BTB in human brain glioma.Conclusion C 6 glioma cells/endothelia cell ECV 304 co-cultures on both sides of membrane of Transwell may simulate the morphological characters of BTB in vivo in some degree.;

Objective To investigate drug resistance and clinical efficacy of second-line anti-tuberculosis drugs in patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 183 multi-drug resistant pulmonary tuberculosis (MDR-PTB) patients received standard anti-tuberculosis treatment in Zhejiang Provincial Center for Diagnosis and Treatment of Tuberculosis during March 2011 and March 2013.Patients were divided into four groups according to the results of first-line anti-tuberculosis drugs susceptibility test:group A (n =30) resistant to isoniazid (H) and rifamipicin (R) ; group B (n =28) resistant to HR and ethambutol (E) ; group C (n =53) resistant to HR and streptomycin (S) ; groups D (n =72) resistant to HRES.Drug susceptibility tests of second-line drugs kanamycin (Km),protionamide (Pto),paraaminosalicylic acid (PAS) and levofloxacin (Lfx) were performed.Negative conversion rates of mycobacterium tuberculosis in sputum culture were also observed and compared among different groups with x2 test.Results Among 183 MDR-PTB patients,49 cases (26.8％) were resistant to Lfx,which was significantly higher than that of Km (8.7％,n =16),Pto (13.1％,n =24) and PAS (6.6％,n=12) (x2 =37.983,P＜0.05).The resistant rate to Lfx in group D was 45.8％ (33/72),which was higher than that in group A (2/30,6.7％),group B (6/28,21.4％) and group C (8/53,15.1％) (x2 =14.413,5.047 and 13.087,P ＜0.05).The occurrence of pre-extensively drug resistance (Pre-XDR) in group D was 34.7％ (25/72),which was higher than that in group A (3/30,10.0％) and group C (9/53,17.0％) (x2 =6.499 and 4.852,P ＜ 0.05).Among 157 MDR-PTB patients who received standard anti-tuberculosis treatment for one year,the negative conversion rate of mycobacterium tuberculosis in sputum culture was 87.3％ (137/157).The negative conversion rate in group D was lower than that in other groups,but the difference was not of statistical significance (x2 =1.899,P ＞ 0.05).Conclusions The efficacies of second-line anti-tuberculosis drugs vary among MDR-TB patients resistant to different firstline anti-tuberculosis drugs.The sensitivity tests results of the first-line drugs may serve as reference for MDR chemotherapy regimen in lack of test results of second-line drugs.

This paper discusses the issues related to research capacity building in a military teaching hospital.We analyzed the opportunities,challenges and proposed development of military hospitals in order to strengthen the collaboration,,to adjust disciplinary structure,to consolidate research platform,to promote international exchanges,and to train the talented researchers and eventually to improve the hospital's overall research capacity.

OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.

Objective To provide the reference for schistosomiasis control through analyzing the changes of endemic status of schistosomiasis in China in recent years. Methods The annual data of schistosomiasis prevention and control from 2002 to 2012 were collected, and the descriptive analysis was conducted to describe the changes of schistosomiasis endemic status. Re?sults Sichuan, Yunan and Jiangxi provinces reached the criteria of transmission controlled from 2002 to 2010 while Hubei, Hu?nan, Jiangxi and Anhui provinces reached the criteria of infection controlled in 2008. The number of counties where the trans?mission of schistosomiasis was controlled decreased from 110 in 2002 to 80 in 2010. The numbers of estimated schistosomiasis cases and reported acute cases fell from 810.4 thousands and 913 in 2002 to 325.8 thousands and 43 in 2010, respectively, and they were reduced by 59.79%and 95.40%respectively. The number of infected bovine went down from 23 199 in 2002 to 7 173 in 2010, with a fall of 69.03%. However, the Oncomelania hupensis snails breeding areas kept in 3.7 to 3.8 billion m2 and among which, 125 million m2 areas were newly discovered in non?endemic areas during the nine years. In 2010, 90%of schistosomiasis cases, acute cases, infected bovine, and snail breeding areas were concentrated in 5 provinces, especially in the Dongting Lake and Poyang Lake areas and the regions along the Yangtze River. Conclusions The epidemic of schistosomiasis decreased sig?nificantly from 2002 to 2010. The lake regions are the key and tough areas for schistosomiasis prevention and control. To consoli?date the achievements, the surveillance and case management need to be strengthened as the extension of snail breeding areas and acute cases reported from other places becomes common.