OBJECTIVETo compare the therapeutic effects of debris spondylectomy, piecemeal spondylectomy, total en bloc spomdylectomy in treating lumbar metastatic tumors.

METHODSThe clinical data of 20 patients with lumbar metastatic tumors treated from January 2008 to October 2013 were retrospectively reviewed. There were 8 males and 12 females, aged from 35 to 65 years old with an average of (49.50 ± 9.97) years. All patients had single solitary metastases. Four cases were in L1,5 cases in L2,4 cases in L3,4 cases in L4, and 3 cases in L5. According to the type of Tomita, type II had in 4 cases, type III in 6 cases, type IV in 6 cases, type V in 4 cases. Tokuhashi score was 12.50 ± 1.97. All patients complained with back or leg pain, VAS score was 8.13 ± 0.85. Among patients, 7 cases were treated with debris spondylectomy (group A), 7 cases with piecemeal spondylectomy (group B), 6 cases with total en bloc spondylectomy (group C). Statistical analysis was used to compare the three groups with respect to surgical trauma (including operative time, transoperative bleeding, and intraoperative blood transfusion), clinical symptoms (by VAS score at 1 week after operation), surgical procedures conditions (by AP and lateral X-rays), and long-term results (by recurrence and death information).

RESULTSAll patients were followed up from 6 to 36 months with an average of (16.50 ± 7.88) months. Operative time for debris spondylectomy was (6.14 ± 0.68) h, intraoperative bleeding was (3 457.14 ± 399.40) ml, and intraoperative blood transfusion was (2 771.43 ± 423.14) ml. Operative time for piece-meal spondylectomy was (4.93 ± 0.61) h, intraoperative bleeding was (1 942.86 ± 378.51) ml, and intraoperative blood transfusion was (1 500.00 ± 336.65) ml. Operative time for total en bloc spondylectomy was(4.17 ± 0.67) h, intraoperative bleeding was (1 341.67 ± 361.13) ml, and intraoperative blood transfusion was (916.67 ± 321.66) ml. There was significant differences in operative time, intraoperative blood loss, and intraoperative blood transfusion between three groups (P < 0.05). In terms of these factors, total en bloc spondylectomy had the best outcome followed by piecemeal spondylectomy. All pains had released, VAS score decreased obviously at 1 week after operation (P < 0.05), and there was no significant differences between three groups (P > 0.05). Surgical effects were well with these methods according to the evaluation of AP and lateral X-rays . At final follow-up, group A had 4 recurrences (2 with breast cancer, 1 with prostate cancer,and 1 with thyroid cancer) and 3 deaths (2 with lung cancer and 1 with thyroid cancer); group B had 2 recurrences (1 with breast cancer and 1 with prostate cancer) and 3 deaths (1 with lung cancer, 1 with breast cancer and 1 with kidney cancer);group C had no recurrences and 2 deaths for lung cancer. There was significant differences in recurrence and death between three groups (P < 0.05). In terms of these factors, total en bloc spondylectomy had the best outcome in three methods.

CONCLUSIONThree kinds of operation method can relieve pain, improve nerve function, increase the spinal stability, control the local lesions, improve the patient's quality of life in treating lumbar metastatic tumors, but total en bloc spendylectomy, respect to operative time, transoperative bleeding, intraoperative blood transfusion, tumor recurrence and death is clearly superior to other two methods.

Adult ; Aged ; Blood Transfusion ; Female ; Humans ; Lumbar Vertebrae ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Operative Time ; Retrospective Studies ; Spinal Neoplasms ; pathology ; surgery ; Spine ; surgery

AIMTo study the effects of ferulic acid (FA) on E-selectin expression in human umbilical vein endothelial cells (HUVECs) activated by lipopolysaccharide and leukocyte-endothelial cell adhesion.

METHODSThe effects of FA on E-selectin and E-selectin mRNA expression were determined by flow cytometry and reverse transcription polymerase chain reaction. The effect of FA on HL60-HUVEC adhesion was evaluated with the method of staining the cells by Rose Bengal.

RESULTSThe expression of E-selectin and E-selectin mRNA were down regulated by FA (0.62 and 0.41 mmol x L(-1), respectively). HL60 cells adhered to activated HUVECs were also reduced by FA (0.62 and 0.41 mmol x L(-1), respectively).

CONCLUSIONFA can inhibit the expression of E-selectin and E-selectin mRNA and HL60-HUVEC adhesion. This may contribute to its protective effect against ischemia-reperfusion injury.

Cell Adhesion ; drug effects ; Cells, Cultured ; Coumaric Acids ; pharmacology ; E-Selectin ; biosynthesis ; genetics ; Endothelial Cells ; metabolism ; HL-60 Cells ; physiology ; Humans ; RNA, Messenger ; biosynthesis ; genetics ; Umbilical Veins ; cytology

Objective To investigate the bacteriological distribution of nosocomial pneumonia induced by acute stroke, and to improve the preventative and therapeutic measures. Methods The clinical data of 192 patients with nosocomial pneumonia induced by acute stroke were analyzed respectively. Results Among the 192 cases, 13 pathogenic microorganisms and 116 strains were cultivated, and the first 4 strains were Escherichia coli, Psendomonas aeruginosa, Klebsiella and Staphylococcus aurens. Gram-negative bacteria were sensitive to imipenem, and Gram-positive bacteria were sensitive to vancomycin. Conclusion The main pathogens of nosocomial pneumonia in acute stroke patients may be Escherichia coli and Pseudomonas aeruginosa. The measures improving the therapeutic outcome of acute stroke include the enhancement of nursing quality, prevention of cross infection in hospital, increasing predictability of the occurrence of pneumonia induced by acute stroke, and the control of pneumonia.

Objective To explore the substantial resection limits of CO2 laser surgery for hypopharynx and the course of wound healing in animals,for the purpose of evaluating the clinic usefulness of transoral CO2 laser surgery in the treatment of selected hypopharyngeal carcinomas.Methods Twenty-three dogs were randomly assigned to two groups.Group one(11 dogs)received left piriform sinus resection,group two(12 dogs)received the resection of posterior wall of the hypopharynx.Six dogs in group one were killed immediately or 4,8,12,16,20 d post-operatively.Seven dogs in group two were killed immediately or 7,14,21,28,35,42 d post-operatively.The whole larynx and hypopharynx were taken out and the specimens were examined by naked eyes and under microscope.The other 5 dogs in each group were fed until the wound healed,the duration were observed.Results All the operations were successful and the results were satisfactory.In group one,the dogs could take food the day after operation;two dogs had slight cough during eating and recovered after five days.In group two,the dogs could take food the next day after operation,eight dogs had slight cough during eating and recovered after ten days.The excision dimensionwas satisfactory.In group one(resection of the lateral wall of piriform sinus),the size of raw surface was (7.5±0.8)cm2((-x)±s) and the healing time was(18.4±1.5)d.In group two(resection of the posterior wall of the hypopharynx),the wound surface was(7.0±0.5)cm2 and the healing time was(39.8±1.9)d.The healing time in group two was significantly longer than that in group one(t=19.535,P<0.01).Thepost-operative healing process were observed,including cellulose membrane coverage,granulation filling andepithelization.Conclusions Transoral CO2 laser was suitable for partial hypopharynx resection.Animalscan recuperate well with little complications.Although the course of wound healing was delayed,wound surface can recover with good laryngeal and deglutition functions.

Objective:To compare the therapeutic effects of debris spondylectomy,piecemeal spondylectomy,total en bloc spomdylectomy in treating lumbar metastatic tumors. Methods:The clinical data of 20 patients with lumbar metastatic tu-mors treated from January 2008 to October 2013 were retrospectively reviewed. There were 8 males and 12 females ,aged from 35 to 65 years old with an average of (49.50±9.97) years. All patients had single solitary metastases. Four cases were in L 1,5 cases in L2,4 cases in L3,4 cases in L4,and 3 cases in L5. According to the type of Tomita,typeⅡhad in 4 cases,typeⅢin 6 cases,typeⅣin 6 cases,type V in 4 cases. Tokuhashi score was 12.50±1.97. All patients complained with back or leg pain , VAS score was 8.13±0.85. Among patients,7 cases were treated with debris spondylectomy (group A),7 cases with piecemeal spondylectomy (group B),6 cases with total en bloc spondylectomy (group C). Statistical analysis was used to compare the three groups with respect to surgical trauma (including operative time,transoperative bleeding,and intraoperative blood trans-fusion),clinical symptoms (by VAS score at 1 week after operation),surgical procedures conditions (by AP and lateral X rays),and long term results (by recurrence and death information). Results:All patients were followed up from 6 to 36 months with an average of (16.50±7.88) months. Operative time for debris spondylectomy was (6.14±0.68) h,intraoperative bleeding was(3 457.14±399.40) ml,and intraoperative blood transfusion was(2 771.43±423.14)ml. Operative time for piece-meal spondylectomy was(4.93±0.61) h,intraoperative bleeding was(1 942.86±378.51) ml,and intraoperative blood transfu-sion was (1 500.00±336.65)ml. Operative time for total en bloc spondylectomy was(4.17±0.67) h,intraoperative bleeding was (1 341.67±361.13) ml,and intraoperative blood transfusion was (916.67±321.66) ml. There was significant differences in op-erative time,intraoperative blood loss,and intraoperative blood transfusion between three groups (P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome followed by piecemeal spondylectomy. All pains had released ,VAS score decreased obviously at 1 week after operation(P<0.05),and there was no significant differences between three groups(P>0.05). Surgical effects were well with these methods according to the evaluation of AP and lateral X rays . At final follow up, group A had 4 recurrences(2 with breast cancer,1 with prostate cancer,and 1 with thyroid cancer) and 3 deaths (2 with lung cancer and 1 with thyroid cancer);group B had 2 recurrences (1 with breast cancer and 1 with prostate cancer) and 3 deaths (1 with lung cancer,1 with breast cancer and 1 with kidney cancer);group C had no recurrences and 2 deaths for lung cancer. There was significant differences in recurrence and death between three groups(P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome in three methods. Conclusion:Three kinds of operation method can relieve pain ,improve nerve function,increase the spinal stability,control the local lesions,improve the patient's quality of life in treating lumbar metastatic tumors,but total en bloc spendylectomy,respect to operative time,transoperative bleeding,intraoperative blood transfusion,tumor recurrence and death is clearly superior to other two methods.

BACKGROUNDAquaporin-1 (AQP1) has involved in fluid transport in diverse pulmonary edema diseases. Our study aimed to explore the dynamic changes of AQP1 in pulmonary water metabolism in rats following traumatic brain injury (TBI) and the protective effect provided by shenmai injection.

METHODSSixty male Sprague Dawley rats weighting 280 - 300 g were randomly divided into three groups: the normal control group, the model group and the shenmai injection (SMI) group. One piece skull was taken away without injuring cerebral tissue in normal control group, while rats in model group and SMI group were subject to free fall injury in the cerebral hemisphere. Rats in model group received intraperitoneal normal sodium (15 ml/kg) at one hour post-injury and the same dose of shenmai injection instead in SMI group, respectively. The expression of AQP1 was detected by immunohistochemical analysis and semi-quantitative RT-PCR at 0 hour, 10 hours, 72 hours and 120 hours after TBI. Arterial blood gas analysis and lung wet to dry were also measured.

RESULTSAQP1 was mainly presented in the capillary endothelium and slightly alveolar epithelial cells in three groups, but the expression of AQP1 in the normal control group was positive and tenuous, weakly positive in the model and SMI groups, respectively. Compared with normal control group, AQP1 mRNA levels were down regulated in the model and SMI groups at 10 hours, 72 hours and 120 hours (P < 0.05). While AQP1 mRNA levels in the SMI group was up-regulated than that in the model group (P < 0.05). Lung wet to dry weight ratio (W/D) in the model and SMI groups at 10 hours were higher than that in normal control group (P < 0.05). Compared with normal control group, PaO2 was markedly lower in the model and SMI groups (P < 0.05), but there were no statistically significant differences between model and SMI groups (P > 0.05).

CONCLUSIONSThe decreased AQP1 expression may be involved in the increased lung water content and dysfunction of pulmonary water metabolism following TBI. The treatment with SMI could improve water metabolism by promoting AQP1 expression.

Animals ; Aquaporin 1 ; genetics ; metabolism ; Brain Injuries ; drug therapy ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Immunohistochemistry ; Injections ; Lung ; drug effects ; metabolism ; Male ; Random Allocation ; Rats ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo assess the efficacy and safety of Dengzhanxixin injection for unstable angina pectoris.

METHODAll clinical studies of Dengzhanxixin injection for unstable angina pectoris (UAP) were searched from Cochrane library, Medline, EM-base, CBM, CNKI, Wanfang and VIP. Quality assessment and information extraction were done by two independent screening . The quality of the included documents was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and allocation concealment. Revman 5.1.4 software was used for data analysis.

RESULTA total of 17 randomized controlled trials were included (1 644 patients), in which, only 2 studies were true RCT, 1 study used single blind method, while other studies did not mention allocation concealment, blind and loss-up information. Meta-analysis showed that the Dengzhanxixin injection group was better than the conventional treatment group in efficiency (OR = 3.54, 95% CI [2.60-4.82]) and ECG (OR = 2.36, 95% CI[1.88-2.96]). Researches with ADR/AE information of Dengzhanxixin injection showed that the symptoms of ADR/AE were slight. This study may exist publication bias.

CONCLUSIONDengzhanxixin injection on the basis of conventional treatment can improve the efficacy of the treatment of unstable angina pectoris. However, due to the sample size of included studies were small and of lower quality, conclusions above still need high-qualitied randomized, double-blind, controlled trials be confirmed.

Adult ; Aged ; Aged, 80 and over ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic

OBJECTIVETo assess the efficacy and safety of Shenmai injection for acute myocardial infarction (AMI).

METHODAll clinical studies of Shenmai for AMI were searched from Cochrane library, Medline, EMbase, CBM, CNKI, Wanfang and VIP. For efficacy analysis of Shenmai, randomized controlled trials (RCTs) and quasi-RCTs were included and the Cochrane Collaboration's RevMan 5.1 was used for data analysis.

RESULT1) Fifty studies were included for efficacy analysis, in which, only 1 study was true RCT, all of studies did not mention allocation concealment, blind and information of loss to follow-up. The fatality rate during hospitalization (OR 0.43, 95% CI [0.31-0.60]), incidence of heart failure (OR 0.49, 95% CI [0.34-0.70]), incidence of shock (OR 0.53, 95% CI[0.30-0.93]) and incidence of re-infarction (OR 0.16, 95% CI [0.03-0.77]) in Shenmai injection plus conventional treatment group was lower than that in the conventional treatment group, while the rate of recanalization (OR 1.24, 95% CI [0.90-1.71]) was similar between the two groups. 2) For safety analysis, we did not found serious adverse drug reaction/adverse events (ADR/AE) of Shenmai injection for AMI.

CONCLUSIONThe currently available evidence showed that Shenmai injection plus conventional treatment group may decrease the fatality rate during hospitalization, the incidence of cardiac failure, shock and re-infarction. However, these findings should be carefully interpreted due to the low methodological quality and small sample size of trials. Although serious ADR/AE was did not report of Shenmai injection, the post-marketing safety evaluation is need to be performed.

Adolescent ; Adult ; Aged ; Child ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; mortality ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Young Adult

Objective:To solve the symptoms of achalasia complicated with osteogensis imperfecta through peroral endoscopic myotomy(POEM).Methods: The 21-year-old male patient,being diagnosed as achalasia complicated with osteogensis imperfecta,underwent POEM under general anesthesia after preoperative assessment of achalasia(Eckardt score of 7).The mucosal incision was made at a distance of 28 cm from the incisor,then the gastroscope entered the submucosal layer and tunnel in it,and myotomy was performed about 29 cm from the incisor extending 2 cm into the cardia.Electrocoagulation was performed to stop bleeding and the mucosal incision was then closed.Results:The operation was completed successfully in about 28 minutes.The stomach tube was removed 30 h after surgery.The patient was discharged in a stable condition on the fourth postoperative day.The follow-up result showed no recurrence in symptom with Eckardt score of 0 two weeks after operation.Conclusions:POEM is a feasible and effective way for achalasia of cardia complicated with osteogenesis imperfecta.

Objective： The aim of this study was to investigate the method of large-scale screening for genes differentially expressed in nonfunctional pituitary tumor and normal pituitary. Methods： cDNA libraries of nonfunctional pituitary tumor (NFPT) and human normal pituitary were constructed. Large-scale sequencing, bioinformatics and semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) were used. Significant difference of known genes expression in 2 tissues were analyzed by statistical software offered by Audic S and Claverie JM (http： //igs-server.cnrs-mrs.fr/). Results： A total of 1253 and 7222 ESTs with good quality were obtained from the tissues of NFPT and normal pituitary, respectively. Two hundred known genes were found in NFPT. Among them, 38 genes creditability of significant difference expression in the 2 tissues were over 0.99, and 130 were over 0.95. Out of the 130 differentially expressed genes in the 2 tissues, 17 genes were associated with cell differentiation and development (G2). 6 differentially expressed G2 category genes were selected and the liability of the expression significant difference in the 2 tissues was confirmed by semi-quantitative RT-PCR. Out of them, 4 were confirmed differentially expressed in the 2 tissues. Conclusion： MEIS2, SMT3C, C1D, and BUB3 genes associated with cell differentiation and development (G2) were expressed more in nonfunctional pituitary tumor than in normal pituitary. They may play a role in the pathogenesis of nonfunctional pituitary carcinoma.