OBJECTIVE: To observe the clinical effect of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly. METHODS: From February 2018 to February 2019, 82 elderly patients with lumbar spinal stenosis and instability were divided into control group and observation group. In the control group, there were 23 males and 18 females;the age was (68.9±4.1) years;the course of disease was (14.1±5.7) months;there were 5 cases of single segment lesions and 36 cases of multi segment lesions;simple bacfuse interspinous fusion was used. In the observation group, there were 22 males and 19 females;the age was (69.1±4.0) years;the course of diseasewas (14.4±5.5) months;there were 6 cases of single segment lesions and 35 cases of multi segment lesions;they were treated with transforaminal endoscopic surgery combined with Bacfuse interspinous fusion. The clinical efficacy, visual analogue scale (VAS), Japanese Orthopaedic Association scores (JOA), Oswestry disability index (ODI), Lehmann lumbar function score, posterior disc height and intervertebral foramen height, complication rate and recurrence rate of the two groups were compared. RESULTS: The clinical efficacy of the observation group was better than that of the control group;the VAS score of the observation group was lower than that of the control group, the JOA score was higher than that of the control group, and the ODI index at 3 months after operation and at the last follow-up was lower than that of the control group, the Lehmann lumbar function score was higher than that of the control group;the posterior edge height of intervertebral disc and intervertebral foramen height were higher than those of the controlgroup;the incidence of complications and recurrence rate (4.9% and 0.0%) of the observation group were lower than those of the control group (19.5%, 9.8%), the difference was statistically significant ( CONCLUSION The clinical effect of transforaminal endoscopy combined with interspinous process fusion in the treatment of lumbar spinal stenosis with instability in the elderly is ideal. It can reduce postoperative pain, improve lumbar function, improve the height of posterior edge of intervertebral disc and intervertebral foramen, and reduce the incidence and recurrence rate. It is worthy of clinical promotion.
Aged ; Endoscopy ; Female ; Humans ; Intervertebral Disc Degeneration ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis/surgery* ; Treatment Outcome

Objective To investigate the geometric feature of femoral medullary cavity through CT scanning and it's matching with femoral intramedullary nail,and to analysis the reason for difficulties in implanting distal lock pin.Methods Thirty dried femur specimens were measured through CT scanning,and twenty images were taken evenly according to the total length of shaft of femur from each femur.In each image,the data of the central axis point and eight points around medullary cavity wall in X and Y axes were obtained,which were used to reconstruct the three-dimensional models of medullary cavity,central axis,intramedullary nail by computer software.And the models were overlapped for comparison.Then the coronal and sagittal fold line charts for central axis of medullary cavity were drawn.The inserting process of intramedullary nail was simulated to observe whether the nail would punch out of the medullary cavity wall.Results The central axis of femoral medullary cavity and intramedullary nail were overlapped and compared.They matched well in the coronal plane,but the curves of femoral medullary cavity were larger than those of intramedullary nails in sagittal plane.While simulating the inserting process of intramedullary nail,6 nails punched out of the medullary cavity wall in coronal plane (20％,6/30),so did 13 nails in sagittal plane (43％,13/30).Conclusion Intramedullary nails match well with most of the femoral medullary cavities.However,the anatomic structure of the femoral medullary cavity differs individually.Curves of some femoral medullary cavity are large,which can cause deformation of intramedullary nail,and this is the main reason for the failure of distal locking.

Objective To reconstruct anatomical structures and establish visible model of the hand and evaluate some key techniques of digitized virtual hand. Methods Three hands were scan and then perfused by self-curing denture acylic and cinnabar. With the datum from CT-scan of the specimen of perfused hand (cryopreserved 4-24 h), such anatomical structures as contour, bone, artery, extensor tendon, flexor tendon and nerve of hand were constructed by software of Mimics 10.01 and measured. Results The visible hand model based on anatomical structures was established and main anatomical structures were exactly showed. Each structure was displayed by the multiform solitude or combination. Vessel lumens was displayed hollow and fidelity. The hand nerve can the part demonstrate that can earnest reflect the normal human body nerve contour anatomy characteristic. Conclusion The visible hand model can provide 3D morphological data for clinical practice and research, as well as provide digitized model for virtual reality.

AIM To establish a RP HPLC method for the determination of zidovudine(AZT) plasma concentration. METHODS A shim pack,VP ODS. 5 ?m 4 6?150 mm radial compression column was used with a mobile phase of tetrahydrofuran water trifluoroacetic acid(10∶89 8∶0 2). The flow rate was 1 0 ml?min -1 .The detector was operated at 267 nm. RESULTS The calibration curves of AZT were linear separately within the concentration range of 0 02～20 mg?L -1 . The relative standard deviations for within day and between days assays were all less than 5%. The relative recovery of the method were 96 4%. The limit of quantitation of the assay is 10 ?g?L -1 of plasma. CONCLUSIONS The methed is rapid,accurate and stable. The determination of AZT plasma concendration could be used.

AIM To study the pharmacokinetics of AZT in mice by encapsulation in liposomes Containing galactosylceramide (GalCer). METHODS AZT was encapsulated in liposomes containing GalCer and the pharmacokinetics of AZT-GalCer and free AZT were observed in mice. RESULTS Higher concentration of AZT in mice injected AZT-GalCer was found in plasma after 30 min and it was ten times as high as in mice injected with AZT. On the other hand, Ke decreased significantly from 0.037 to 0.021 h -1 , T_ 1/2 Ke increased significantly from 19 min to 35 min, and AUC was 2.77 times as high as in mice injected with AZT. CONCLUSIONS AZT-GalCer serving as a dilivery carrier could prolong the effective concentration of AZT in plasma. AZT-GalCer might have great therapeutic potential for treating AIDS.-

Background and purpose:Epidermal growth factor receptor (EGFR) gene mutation is the most important predictive factor for determining the effectiveness of EGFR tyrosine kinase inhibitors (TKIs) for non-small cell lung cancer (NSCLC). This study aimed to determine the clinical application value of mutation-speciifc immu-nohistochemistry forEGFR mutation detection in NSCLC.Methods:Mutation-specific immunohistochemistry and ampliifcation refractory mutation system (ARMS) were used simultaneously to detectEGFR gene mutation status in 290 lung cancer specimens. The sensitivity, speciifcity, positive predictive value (PPV) and negative predictive value (NPV) of mutation-speciifc immunohistochemistry for detectingEGFR gene mutations were evaluated. The consistency was analyzed between mutation-speciifc immunohistochemistry results and ARMS results.Results:With ARMS testing as the gold standard, when a cutoff value of score 1+ was used as positive by immunohistochemistry, the sensitivity of mutation-speciifc immunohistochemistry forEGFR gene mutation was 72.92%, speciifcity 95.20%, positive predictive value 93.75% and negative predictive value 78.08%. The accuracy of immunohistochemistry was obviously different when variousEGFR gene mutations were detected. The sensitivity of immunohistochemistry for exon 19 deletion was only 55.55%, but speciifcity was above 99%. When immunohistochemistry score was 1+, the sensitivity for L858R mu-tation was 90.27%, whereas speciifcity was 95.86%. When immunohistochemistry score was 2+ or 3+, the speciifcity for L858R mutation was 98.63%-100%. The results of mutation-speciifc immunohistochemistry were ifnely correlated with mutation status determined by ARMS assay (P<0.001, Kappa value: 0.612-0.864). Mutation-speciifc immunohis-tochemistry can directly determineEGFR gene mutation abundance at the cellular level.Conclusion:Mutation-speciifc immunohistochemistry could be an effective supplemental method toEGFR molecular tests.

Objective To evaluate the diagnostic value and safety of domestic electromagnetic navigation bronchoscopy (ENB) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions.Methods Sixty-four patients with peripheral pulmonary lesions shown by thoracic CT in Zhongshan Hospital,Fudan University between Jul.and Dec.,2014 were collected.The patients were randomly assigned to test group (underwent ENB in combination with X-ray guided TBLB) and control group (underwent X-ray guided TBLB).The final diagnosis was confirmed by pathologic examination of surgically removed lesions or by 24 months clinical follow-up.The operative time as well as the intraoperative and postoperative complications were also recorded.Results Sixty-four patients had 70 peripheral pulmonary lesions.There was no difference in age,sex,the lesion size or location between the two groups.Pathology results showed that the diagnostic yield of test group and control group were 88.6％ and 62.9％,respectively,with statistical significance (P =0.012).Subgroup analysis showed that if the lesion's diameter was ≤2 cm,the diagnosis yield of test group was higher than control group (66.7％ vs.20.0％,P =0.266);if the lesion was ＞2 and ≤3 cm,the diagnosis yield of test group and control group were 100 ％ and 81.8 ％,respectively (P =0.485).But if the lesion was＞3 cm,the diagnostic yield of the 2 group was significantly different (94.4 ％ in test group,63.1％ in control group,P =0.042).Mean operation duration of the 2 group was (966 ± 372)s and (1 040 ± 470) s,respectively,with no statistical difference (P =0.600).However,there was statistical difference between the 2 groups on the X-ray time needed to find the pulmonary lessions [(7.0 ± 4.8)s vs.(37.0 ± 37.5) s,P =0.008).There was no pneumothoraxes and excessive bleeding in patients undergoing ENB.Conclusions Compared with X-ray guide TBLB,ENB guided TBLB for peripheral pulmonary lesions has a certain degree of security,and has superiority in reducing the X-ray time required to find the lesion and improving diagnostic yield especially when the lesion's diameter was ＞3 cm.

This study was purposed to comparatively analyse the value of PCR and FCM for dynamic monitoring minimal residual disease (MRD) of acute promyelocytic leukemia. The patients with acute promyelocytic leukemia hospitalized in our hospital from January 2011 to December 2012 were observed and all achieved complete remission after remission induction therapy. Before the chemotherapy, the bone marrow cell morphology examination, polymerase-chain reaction (PCR) and multi-parameter flow cytometry (FCM) were performed for each patient. Then the detection results were statistically analyzed. The 477 specimens were achieved from 159 detections for 48 patients. The results showed that 3 specimens were found to be relapsed by bone marrow cell examination, and other specimens were complete remission;PCR detection confirmed 7 positive, and the FCM confirmed 19 positive. There wasn't significant difference between PCR and FCM by kappa test (P > 0.05). It is concluded that FCM is as sensitive as PCR in evaluating the treatment effect of acute promyelocytic leukemia.
Adolescent ; Adult ; Aged ; Female ; Flow Cytometry ; methods ; Humans ; Leukemia, Promyelocytic, Acute ; therapy ; Male ; Middle Aged ; Neoplasm, Residual ; therapy ; Polymerase Chain Reaction ; methods ; Prospective Studies ; Young Adult

Objective::To investigate the effect of Bletillae Rhizoma polysaccharide on the expressions of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) gene protein and its mediated cytokines interleukin-2 receptor (IL-2R) and interleukin-4 (IL-4) in gastric tissue of rats with gastric ulcer (GU). Method::Sixty SPF Wistar rats were randomly divided into blank group and model group.The GU model was replicated by direct acetic acid cauterization in model group.The GU model rats were randomly divided into five groups: model group, positive control group, and large, medium and small-dose Bletillae Rhizoma polysaccharide groups, with 10 rats in each group.Rats in blank group and GU model group were given 10 mL·kg^-1·d^-1 distilled water by gavage, rats in large, medium and small-dose groups were given 0.5, 0.25, 0.125 g·kg^-1·d^-1 Bletillae Rhizoma polysaccharide by gavage, while rats in positive control group were given 0.3 g·kg^-1·d^-1 ranitidine by gavage for 15 days.Serum nitric oxide (NO) content, pepsinase activity and cytokines IL-2R and IL-4 levels in rats of each group were measured by enzyme-linked immunosorbent assay (ELISA), PI3K and Akt mRNA expressions were detected by Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), and PI3K and Akt protein expressions were detected by Western blot. Result::Compared with the blank group, the contents and gene expressions of cytokines IL-2R and IL-4 in gastric tissue were significantly increased, and the PI3K and Akt genes and protein expressions were significantly increased, with statistical significance (P<0.01). Compared with GU model group, the content and gene expressions of IL-2R and IL-4 in large, medium and small-dose Bletillae Rhizoma polysaccharide groups were decreased significantly, and the PI3K and Akt gene and protein expressions were decreased significantly in large-dose Bletillae Rhizoma polysaccharide group, while those in large and medium-dose Bletillae Rhizoma polysaccharide groups were decreased significantly (P<0.05, P<0.01). Conclusion::Bletillae Rhizoma polysaccharide can protect gastric mucosa by down-regulating PI3K and Akt gene and protein expressions and inhibiting abnormal secretion of cytokines IL-2R and IL-4.