Objective To evaluate the outcomes of microdiscectomy for treatment of recurrent lumbar disc hemiations. Methods There were 18 cases of recurrent lumbar disc berniations accepted microdiscectomy (reoperation group), compared with 30 cases of primary lumbar microdiscectomy (primary group). Operating time, blood loss and length of hospital stay were compared between two groups. MacNab criteria were used to evaluate the outcomes. Results Operating time was a mean of 75 min in reoperation group, 52 min in primary group. Blood loss of reoperation group was 70 ml, 50ml in primary group. Length of hospital stay was 8.5d in reoperation group, 6.5d in primary group. There were one dural tear, two Ls root lesions and 5 more numbness reoperation group, but recovery all patients. There were one dural tear in primary group. 17 cases got follow-up mean 12.1 months in reoperation group and 29 cases in primary group mean 11.8 months. The results demonstrated 88.2% success rate in reoperation group and 93.1% in primary group. There was no significant dif-ference in two groups (P ＞ 0.05). Conclusion Outcomes of Lambar mierodisceetomy with mini-open for treatment of recurrent lumbar disc herniations are similar to primary lumbar mierodiscectomy.

Objective To evaluate the primary outcomes of minimally invasive lumbar microdiscectomy. Methods There were 34 cases with single lumbar disc herniation treatment of tubular retractor access with METRx system and microdiscectomy(MMD group)and same cases with treatment of conventional discectomy(CD group).Operating time,blood loss,time of leaving the bed and length of hospital stay were compared in two groups.The postoperative wound pain was measured using a visual analog scale(VAS).The modified MacNab criteria were used to evaluate the outcomes. ResuIts The mean operating time was 65 min in MMD group,63 min in CD group.The mean blood loss was 34 ml in MMD group,85 ml in CD group.To compare in two groups,there was significant difference(P＜0.05).The mean time of leaving the bed after operation was 3.2 d in MMD group.5.8 d in CD group.The mean length of hospital stay was 5.8 d in MMD group.9.6 d in CD group.The mean VAS of the postoperative wound pain was 3.2 scores in MMD group,5.6 scores in CD group.To compare in two groups,there was significant difference(P＜0.05).There was one complication in MMD group,4 in CD group.Thirty-three cases got follow-up mean 8.5 months in MMD group.The success rate was 93.9%. Conclusion The minimally invasive lumbar microdiscectomy has the advantages on less trauma,safety,quickly postoperative recovery,and satisfactory outcomes.

[Objective]To report the initial outcomes of occipitocervical fixation using plate-rod-polyaxial screw system and investigate whether this new system offers any advantage over other existing methods of fixation.[Method]Fourteen cases(male 9,female 5)accepted cervicooccipital fixation with plate-rod-polyaxial screw system.There were 3 cases of odontoid dysplasia with dislocation;spinal canal tumor in 3;2 cases of metastatic carcinoma with pathologic fracture of C_1 and C_2,rheumatoid arthritis with cervicooccipital instability,and fasilar impression;burst fracture of C_1 with oecipital-atlantal-axial instability in 1.Twelve cases had neck pain.Thirteen cases had neurological deficits in different degrees.JOA score was 12.4 on average.[Result]The positions of all screws were good.There was no complication related to inserting screws.All neck pain released.Fourteen-months follow-up was obtained on average in 13 patients.Cervicooccipital nonunion was in one case and its occipital screws were pulled out.Twelve patients had satisfactory fixation and got firm fusion.Ameliotate rate of JOA score of the neurological function was 63.0%.[Conclusion]These initial data indicate that posterior occipitocervical fixation using plate-rod-polyaxial screw system is safe and reliable,and satisfactory clinical outcome can be obtained.The system appears to offer some advantages over other existing methods of fixation.

Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3 × 109/L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups , while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g/(kg·d) for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients’ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group. Moreover , the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts , shorten the in-ICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia (PLT count < 30 × 109/L).

AIM: To investigate the effects of polidatin on phospholipase A_2(PLA_2),nitric oxide(NO),and endothelin-1(ET-1) levels in serum and lung homogenate of hypoxic pulmonary hypertension rats.METHODS: 29 healthy Spraugue-Dawley rats were randomly divided into normal control group,chronic hypoxic group and hypoxic plus polidatin group.The model of chronic hypoxic pulmonary hypertension was made by method of intermittent isobaric hypoxia for 21 days.The mean pulmonary arterial pressure(mPAP) was measured by inserting a microcatheter into the pulmonary artery.The ratio of right ventricular wall and that of left ventricular wall and ventricular septum weight(R/L+S) was measured as well.RESULTS: After exposed to hypoxia for 21 days,the mPAP,R/L+S,PLA_2 and ET-1 activities in blood and lung homogenate increased significantly. The NO concentration decreased significantly.Pretreatment with PD attenuated these changes mentioned above.CONCLUSION: Pretreatment with PD effectively prevents the formation of chronic hypoxic pulmonary hypertension.Its mechanism may be related to the inhibition of PLA_2 and ET-1 and promotion of NO production.

AIM: To determine the topographic and spactial changes of endothelin-1 (ET-1) mRNA in cords after spinal cord injury(SCI). METHODS: A SCI model of the rat was made by modified Allen's weight drop method(50g-cm). ET-1 mRNA in the spinal cords before and after injury was examined by in situ hybridization and the content of ET-1 mRNA was determined by semi-quantitative image pattern analysis. RESULIS: Compared with control, the ET-1 mRNA positive neurons, glial cells and endothelial cells increased and the positive signal enhanced in the adjacent cord of the contused region. There was also a significant increase in positive unit of ET-1 mRNA staining in injured spinal cord except 48 h-group. The quantity of neuron expressing ET-1 mRNA decreased gradually in contused region after SCI, while the quantity of glial cell expressing ET-1 mRNA increased. CONCLUSION: Expression of ET-1 mRNA upregulates in spinal cord after SCI. It suggests a pathophysiological role for ET-1 in SCI. Neuron is the main contributor to the increase for ET-1 in injured spinal cord.

AIM: To study the relationship between the activity of phospholipase A 2 (PLA 2) and pulmonary structural remodeling with the model of chronic isobaric hypoxic pulmonary hypertension. METHODS: 29 healthy Sprague-Dawley rats were randomly divided into normal control group, chronic hypoxic group and hypoxia plus Polidatin (PD) group. By diameter, the arteries were divided into two groups: arteries of group I (30 ?m-100 ?m) and group II (101 ?m-200 ?m). The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The PLA 2 activity was measured with modified microtitrimetic method. The pulmonary tissue and arterioles morphology changes were examined under light microscope. RESULTS: It was found that after 21 days hypoxia, the mean pulmonary arterial pressure (mPAP), the PLA 2 activity in blood and lung homogenate increased significantly. The media thickness of group I arteries increased (P

Objective To investigate the effect of morphine preconditioning on mitochondrial permeability transition pore (MPTP) and its protective mechanism after myocardial ischemia-reperfusion injury. Methods A rat model of ischemia-reperfusion injury was established. Forty rats were injected with 2-3[H] DOG and then divided into 4 groups randomly: a sham operation (S) group, an ischemia-reperfusion injury (IR) group, a morphine preconditioning (Mp+IR) group, and a cyclosporine A preconditioning (CsA+IR) group. We monitored the concentrations of serum creatine kinase-Mb (CK-Mb) and cardiac troponin I (cTnI), and measured myocardial mitochondrial 2-3[H] DOG, cytochrome c content, Ca2+ concentration ([Ca2+]m), the velocity of Ca2+ intake and reaction half time of mitochondrial permeability transition pore (MPTP t1/2) in the 4 groups. Results The concentrations of serum CK-Mb and cTnI decreased more in the Mp+IR group and the CsA+IR group than those of the IR group. The concentrations of 2-3[H]DOG and [Ca2+]m in the IR group were evidently higher but the level of cytochrome c was lower than those of the sham operation group. The concentrations of 2-3[H] DOG and [Ca2+]m in the Mp+IR group decreased whereas the concentration of cytochrome c increased compared with those in the IR group. Mitochondrial 2-3[H]DOG content was positively correlated with the concentration of calcium (r=0.797, P<0.01). The 2-3[H]DOG and [Ca2+]m content were negatively correlated with cytochrome c in the IR group (r=-0.805 and r=-0.648, respectively, P<0.01). MPTP t1/2 in the IR group was shortened evidently, and that in the Mp+IR and CsA+IR group was significantly lengthened. Conclusion Morphine preconditioning may have myocardial protective effect through unburdening the calcium overload and lengthening the MPTP t1/2.

Objective To summarize the enperience of medical rescue and rdlief work in flood disaster at over seas. Method From August,26 to September14, 2010, China's international medical rescue team urgently ordered by the Chinese gevernment for the first time went to join the Pakistan flood disaster medical relief mission to carry out international humanitarianism rescue work. Aiming directly at infectious diseases prevention and treatment after flood disaster, organized medical rescue team from the hospital; consummated medical rescue plan; equipped with medical materials; established medical profession safety regulation. Results Through 18 days hard working,China's international medical rescue team received 11 243 persons, and treated 11020 patients. Conclusions China is one of the first countries to join the Pakistan flood disaster medical relief mission.

Humans ; Pulmonary Embolism ; Pyrazoles ; Pyridones ; Venous Thrombosis