OBJECTIVE:To investigate the influence of nitrogen monoxide(NO) donor,sodium nitroprusside(SNP),on mRNA expression of sodium/iodide symporter(NIS) in thyrocyte membrane cultured in vitro in order to interpret molecular mechanism that NO inhibits the uptake of iodide.METHODS:The effect of SNP at different concentrations(0,10-6,10-5,10-4,10-3 mmol?L-1) on mRNA expression of NIS in thyrocyte by using cell culture method and RT-PCR with optical density ratio of NIS/?-actin as index.RESULTS:Optical density ratio of NIS/?-actin in each group decreased in order after treated with SNP(0,10-6,10-5,10-4,10-3 mmol?L-1).NO inhibited mRNA expression of NIS in a dose-dependent manner(P

With the change of diet and lifestyle,the development of medical concepts and techniques,the spectrum of disease has changed dramatically. The standardization of gastrointestinal surgery will be the key to further improvement.Endoscopic ultrasonography,computed tomography,magnetic resonance imaging, positron emission tomography-computed tomography and laparoscopy are helpful for preoperative staging of gastrointestinal carcinoma.The standards of operation,such as D2 lymph node dissection for gastric cancer and total mesenteric excision for rectal cancer,are also very important.Creating standards for multi-disciplinary treatment of gastrointestinal diseases will be important factors for improving outcomes.

Objective To evaluate the clinical value of humeral antegrad e interlocking nails. Method 21 patients with humeral shaft fracture were treate d with open reduction and internal fixation with antegrade interlocking nail. Re sult The patients were followed up for 3 to 20 months (mean 14.6months). All pat ients acquired bone healing, and only one case had temporary injury of radius ne rve. Conclusion The humeral antegrade interlocking nail is an effective method t o treat humeral shaft fracture, with advantages of good elbow function and less complications of infection and injury of radius nerve.

Objective To evaluate the clinical effect of thoracic discectomy via trans-facet-joint approach in the treatment of thoracic disc herniation.Methods Thirty-three cases were included in this group from October 1994 to August 2009.There were 27 males and 6 females.The age ranged from 18 to 72 years old,with an average of 41.8 years.The course of disease ranged from 12 days to 36 months and was lesser than one month in 13 cases.The weakness and numbness of lower limbs occurred after trauma in 9 cases.Fifteen cases were diagnosed as simple thoracic disc herniation.Six cases were associated with ossification of posterior longitudinal ligament and 12 cases were associated with ossification or hypertrophy of yellow ligament.A total of 45 discs were involved,including 32 in lower thoracic segments(71.11%),8 in upper thoracic segments(17.78%)and 5 in middle thoracic segments(11.11%).All the herniated discs and the ossified OPLL were excised via the trans-facet-joint approach.For the cases with ossification or hypertrophy of yellow ligament,the laminectomy and replantation were performed.The screw-rod system was used on both sides in 14 cases,on one side in 19 cases.Results Follow-up was acquired in 27 patients,ranged from 12 to 63 months(mean,37 months).According to Epstein and Schwall grade,there were excellent in 15 cases,good in 10 cases,improved in 2 cases and poor in 2 cases.The excellent and good rate was 86.21% and total effective rate was 93.10%.Postoperative complications occurred in 3 cases,including exacerbation of preexisting deficits in 2 cases and implant failure in 1 case.The former 2 cases were treated with methylprednisolone,dehydrant,neural nutrition and hyperbaric oxygen.One patient had recovered to preoperative level,the other had not recovered to the preoperative level.The implant was removed 18 months after operation for the implant failure.The post-operative CT or MRI showed that all the replanted lamina obtained fusion,and the canal decompression was complete.Conclusion Thoracic discectomy via trans-facet-joint approach can improve the clinical result obviously.

BACKGROUND: Xenograft cortical bone is an easy and inexpensive bone graft material, which has good biocompatibility and bio-mechanical properties. As a bone graft, it can function as biological framework for new bone growth and bio-supporting. Moreover, it can also be processed into internal fixation devices.OBJECTIVE: To review the biological properties, preparation methods and clinical applications of heterogeneous cortical bone for fracture fixation.METHODS: A computer-based online search of Pubmed database (1990-01/2009-05) and CNKI (1990-01/2009-05) was performed for related articles with key words of "Xenograft cortical bone, Bone graft, Fixation" in English and Chinese.RESULTS AND CONCLUSION: A total of 128 articles were collected. Xenograft cortical bone has a good biological performance, in particular, a certain degree of bio-mechanical properties. It is not only able to complete bone filling, bone induction, but also function as internal fixator following processing. However, the traditional preparation process reduces their bio-mechanical properties. Heterogeneous cortical bone can be widely used in intra-articular fractures and cancellous bone fracture fixation, and can be self-absorbed, avoiding the second operation. However, its instability limits its initial mechanical properties of fractures at other sites.

ObjectiveTo assess the clinical value of minimally invasive transforaminal lumbar interbody fusion(TLIF) through the Wiltse approach for the treatment of lumbar spondylolisthesis. Methods Sixty-nine patients with lumbar spondylolisthesis were randomly divided into two groups. Group A underwent minimally invasive TLIF via the Wiltse approach, Group B via the traditional approach. There were 31 cases in group A, the affected level was L4.5 in 19 cases and L5S1 in 12. The degree of vertebrae slippage was Ⅰ degree in 17 cases,and Ⅱ degree in 14. There were 38 cases in group B, the affected level was L4,5 in 22 cases and L5S1 in 16. The degree of vertebrae slippage was Ⅰ in 21 cases, and Ⅱ in 17. The Japanese Orthopaedics Association (JOA) score, visual analogue scale (VAS) of low back pain and leg pain were evaluated at 3, 6, and 12 months follow-up. The post-operative dynamic X-rays, CT and/or MRI were used for image evaluation. ResultsThere was no statistically difference in operating time between the two groups. The incision length, blood loss and exposing time of group A were shorter than those of group B. The JOA scores, recovery rate, VAS of low back pain and leg pain, interbody fusion rate and atrophy rate of multifidus in group A were 24.7±3.5, 77.0％±3.1％, 1.0±0.7, 1.1±0.3, 71.0％±5.8％, 2.1±0.2, respectively, and in group B were 24.3±2.8, 73.6％±6.4％, 3.1±0.6, 1.8±0.5, 76.3％±6.1％, 0.5±0.1, respectively. The VAS of low back pain was lower in group A than in group B. The atrophy rate was better in group A than in group B. Conclusion Both TLIF approaches can acquire satisfactory clinical results. Minimally invasive TLIF through the Wiltse approach can significantly reduced damage of multifidus and incidence of chronic low back pain postoperative.

[Objective] To observe the influence of blood-nourishing and wind-expelling therapy on the therapeutic effect of epidermic grafting for vitiligo. [Methods] Sixty-two patients with vitiligo were allocated to group A (n = 32) and group B (n = 30) with simple random method. Group B was treated with epidermic grafting. Group A was treated with oral use of Baibofeng Decoction (mainly composed of Radix Angelicae Sinensis, Caulis Spatholobi, Radix Saposhnikoviae, Fructus Psoraleae, Radix Paeoniae Rubra , Radix Salviae Miltiorrhizae, etc.) 2 weeks after epidermic grafting was performed, one dose every other day, and with external application of Fubu tincture (composed of Fructus Psoraleae, Radix Angelicae Dahuricae, Radix Salviae Miltiorrhizae and Flos Carthami) bid. After treatment, the short-term and long-term therapeutic effect was observed in the two groups. [Results] The cure rate was 83.6% and the effective rate was 93.1% in group A, and respectively 71.0% and 88.5% in group B, the therapeutic effect of group A being better than that of group B (P

The application of molecular biological technique provides opportunity to pancreatic cancer patients since the cancer is resistant to routine treatment. Clarifying the molecular mechanism in the genesis and development of pancreatic cancer is the first thing to do. Recent researches found that there were different signaling pathways activated in different stages of pancreatic cancer. The important signal pathways included mitosis pathways, growth factor pathways, developing pathways and mucin pathways. This article will review the relationship between molecular pathways and pancreatic cancer.

Objective To report the results using endoscopic techniques in ce rvical discectomy and intervertebral fusion. Methods From October 2002 to August 2003, 26 patients underwent cervical discectomy and intervertebral fusion using endoscopic techniques. 16 patients had been followed-up more than 3 months, inc luding 4 females and 12 males. The average age was 53.2 years (range, 23 to 65 y ears). The disorders lasted from 3 to 14 months before surgery. There were 3 cas es of cervical injury associated cervical disc herniation (CDH), 8 of cervical s pondylotic myelopathy (CSM), 2 of solitary ossification of the posterior longitu dinal ligament (OPLL), and 3 of radiculopathy. The mean preoperative ADL of Japa nese Orthopedic Association (JOA) score was 7.2. The working channel was inserte d through a 2 cm long incision, the protruded discs or ossified posterior longit udinal ligaments were excised for complete decompression, then an appropriate in tervertebral PEEK fusion cage was implanted. Results All patients obtained endos copic cervical discectomy and interbody fusion successfully. None of cases was c onverted to open procedures. The surgery lasted an average of 120 min (range, 50 to 150 min), mean blood loss was 110 ml (range, from 40 to 140 ml). There was n o complication during operation and no any stimulating symptoms on laryngopharyn x after surgery. However, postoperative hemorrhage of the incision occurred in 1 case, then an injury of a thyroid vessel was found during immediate exploration . The follow-up period extended from 3 to 8 months (mean, 6.5 months), the aver age preoperative ADL of JOA score was 13.1 while the improvement rate was 60.2%. Conclusion The cervical discectomy and intervertebral fusion through endoscopi c approach is able to reduce the soft tissue injury and the incidence of stimula ting symptoms on laryngopharynx, which makes the surgery more safe. The indicati ons for this procedure include cervical disc herniation, cervical myelopathy, ra diculopathy, and traumatic cervical disc injury on C3,4 to C5,6 segments.

Objective To summarize the imaging features of the thoracic canal stenosis caused by ossification of ligamentum flavum, and to evaluate its clinical results of a novel decompression of total laminotomy and autografting in-situ. Methods 31 patients underwent total laminotomy, autografting in-situ and decompression to treat the ossification of thoracic ligamentum flavum. In the study, there were 18 males and 13 females; the average age was 45.7 years (rang, 26 to 73). 3 patients were associated with cervical stenosis, 5 with lumbar stenosis, and 2 with both cervical and lumbar stenosis. 9 were associated with anterior compression by thoracic disc herniation or OPLL. The vertebrae affected were 1 level in 3 patients, 2 levels in 12, 3 levels in 11 and more than 4 levels in 5. 23 affected segments were located at the upper thoracic spine(T1-T4), 19 at the mid-thoracic spine(T5-T8) and 52 at lower-thoracic spine(T9-T12). All the patients underwent total laminotomy and autografting in-situ, 9 patients with thoracic disc herniation or OPLL received discectomy and internal fixation at one stage. The postoperative outcomes were evaluated according to Epstein criteria. Results The patients were followed up 6 to 63 months (mean, 15 months). The clinical outcomes were excellent in 14 cases, good in 7 cases, and fair in 3 cases, and the excellent and good rate was 87.5%. One case experienced neurological complication with Frankel C grade improved to Frankel D grade treated with neurotrophic drug and hyperbaric oxygen and to Frankel E grade at 5 months after operation. 2 presented with lower limb intravenous thrombosis, and CSF leakage happened in 1 case and cured with re-operation. The osteotomy of total laminotomy was bony healed at average of 5.5 months, and there was not new formed ossification anterior to re-implanted vertebral lamina and spinal cord compression. Conclusion MRI combined with CT scanning is a most useful imaging modality for the diagnosis of ossification of thoracic ligamentum flavum. The novel surgical procedure designed by the authors is safe and effective in treating ossification of thoracic ligamentum flavum.