Tumors of the sacrum are rare.The valve of adjuvant is uncertain,and en bloc tumor resection remains the primary mode of treatment.But en bloc tumor resectiong often leads to unstability of the pelvic ring.Therefore,the most factor providing the successful outcome in the management of sacral tumor is how to establish stability in the lumbo-sacrai junction.The various spinopelvic reconstruction techniques are reported in the literature.This includes various methods triangular frame reconstruction,or lilac rod or iliac screw fixation,modified galveston,custom-made prosthesis and so on.The authors review the modes of reconstruction after sacral tumor resection and discuss the outcomes.

BACKGROUND:Currently, transplantation of bone marrow mesenchymal stem cel s into the spinal cord is very limited to the recovery of animals fol owing spinal cord injury. Methylcobalamin is a common drug for the treatment of neurological diseases and injuries, but its effects on bone marrow mesenchymal stem cel s are unclear. OBJECTIVE:To study the feasibility of bone marrow mesenchymal stem cel s differentiating into neuron-like cel s induced by methylcobalamin in vitro and to observe the cel viability and proliferation of differentiated cel s. Methods:Rat bone marrow mesenchymal stem cel s were isolated, cultured and purified by density gradient centrifugation and adherent culture. The fourth to fifth generation of bone marrow mesenchymal stem cel s were treated for 24, 48 and 72 hours with different concentrations (25, 50 and 100 mg/L) of methylcobalamin. The morphological changes and cel growth were continuously observed under an inverted phase constract microscope. The viability of induced cel s was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expressions of Nestin and neuron-specific enolase were identified by reverse transcription PCR and western blot. RESULTS AND CONCLUSION:Most of bone marrow mesenchymal stem cel s could differentiate into neuron-like cel s after induction with methylcobalamin. The expressions of Nestin and neuron-specific enolase were up-regulated after 48 hours of methylcobalamin treatment at different concentrations, especial y after treatment with 100 mg/L methylcobalamin. Similarly, the expressions of Nestin and neuron-specific enolase could be increased significantly after 100 mg/L methylcobalamin treatment for 24, 48 and 72 hours, especial y for 72 hours. It is indicated that methylcobalamin can induce bone marrow mesenchymal stem cel s differentiating into neuron-like cel s, and the optimal concentration of methylcobalamin is 100 mg/L.

Objective:To analyze the visualized citation of evidence in the research fields of clinical pharmacy. Methods: The visualized citation analysis tool HistCite was used, and science citation index-expanded core collections in Web of Science was applied to obtain the data. Biliometric analysis, citation analysis and visualization technology were used to investigate the number and year-dis-tribution, country and region, distribution of research institutions and core authors of the literatures in clinical pharmacy research fields. Results:During 2002 to 2013, the number of literatures of clinical pharmacy was increased year by year. The literatures were published mainly in 62 countries and regions, especially in the United States of America. The major research institutions were college of pharmacy in university. Conclusion: Over the past decade, the research on clinical pharmacy is increased rapidly. The software HistCite can reveal the development track of clinical pharmacy research fields quickly and visually.

ObjectiveTo evaluate the treatment strategy for patients with abdominal aortic aneurysm (AAA) and concomitant digestive system diseases (DSD) necessitating a surgery.Method From Mar. 1999 to Oct. 2001, clinical result of 6 cases suffering from concomitant AAA and DSD was reviewed. The AAA ranged from 4 8 to 11?cm in diameter. Cholecystectomy (for acute cholecystitis) and sigmoidectomy (for colonic cancer) were performed synchronously with AAA repair in 2 cases and 1 case respectively. Right semicolonectomy, radical subtotal gastectomy and esophagogastrectomy (all for carcinoma) were performed heterochronously with AAA endovascular exclusive grafting in one each patient, ResultGastric paresis developed postoperatively and recovered spontaneously in one patient. Esophagogastroanastomosis leakage caused a death in 1 patient. With follow up of 6～42 months the remaining 5 patients were alive, with no graft infection, nor cancer recurrence. ConclusionThe concurrent presentation of AAA and digestive tract diseases necessitating surgical intervention could be successfully managed synchronously or heterochronously.Endovascular exclusive graft of AAA is an effective therapy in patiens suffering from concomitant AAA and DSD.

To study the effects of 70%Hepatectomy on the proliferation of rat fetal hepatocytes after intrasplenical transplantation, fetal hepatocytes isolated from 3 week SD rat fetuses bred were transplanted into the spleens of liver regeneration model rats with 70% partial hepatectomy. The cell cycle of hepatocytes in the remanent liver was analyzed by flow cytometer and the density dimensions of the donor fetal hepatocytes in spleen were measured by Image Analysis System 7 and 30 days post transplantation respectively. Compared with the control group, the proportions of S state cells in the remanent liver were obviously increased ( P

Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During the follow-up period ,there were no tuberculosis recurrence ,no loosening of in-ternal fixation ,and no break of rod and nail ;the grafted bones were fused in all patients with an average time of 7 .5 months ;accord-ing to Frankel grade of nerves function ,only one patient was grade D ,while the other four cases recovered to grade E .The lumbosa-cral angle of patients was corrected from 23 .8° ± 4 .0°(19 .8°-27 .8°) before surgery to 29 .1° ± 3 .6°(25 .5°-32 .7°) after surgery , and the change was statistical significance(P<0 .05) .Conclusion The one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach inside of rectus abdominis is a safe and effective meth-od ,which can thoroughly remove the focus ,reconstruct the lumbosacral stability ,and prevent the loosening of bone grafting .

Objective To further elaborate the clinical characteristics,diagnosis,treatment and prognosis of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma.Methods The clinical characteristics,diagnosis and treatment of a patient with primary cutaneous invasive epidermotropic CD8 positive cytotoxicity T-cell lymphoma were summarized,and diagnosis and treatment of the disease from published literature were reviewed.Results After one year long,recurrence of exudative maculopapule on his body and limbs,a middle-aged male patient visited our hospital.Then,the patient was diagnosed as T2N0M0 Ⅰ phase of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma based on results of skin biopsy,immunohistochemistry,T-cell gene rearrangement and PET-CT.Through integrative medicine treatment (combination of bruceolic oil emulsion and chemotherapy with GDP regimen),the patient achieved complete remission (CR).The treatment and follow-up continues till now and his condition was stable.Conclusions Clinical occurrence of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma is rare and early diagnosis is difficult.It could be diagnosed with histopathology combined with T-cell gene rearrangement.In order to avoid misdiagnosis,great caution should be taken during disease history inquiry and physical examination,should be early lesion for delayed healing of recurrent lesions,biopsy should be conducted as soon as possible and immunohistochemistry should be performed simultaneously,which will provide a good basis for further treatment.

Objective To compare among three different methods in performing hepatic vascular blockade during hemihepatectomy for primary hepatic carcinoma ( PHC). Methods Between 2000 and 2005, 83 PHC patients underwent the Pringle's maneuver (Group A) , 67 cases in combination Pringle's maneuver and inferior vena cava (IVC) clamping (Group B) , and 32 cases received anatomical blood flow blockade for the half liver for hemihepatectomy ( Group C). Results Operation time in group C was longer than that in group A and B(t =3. 27、2. 74,all P

AIM: To study the effect of environment of liver regeneration on the proliferation of rat fetal hepatocytes after intrasplenical transplantation. METHODS: Fetal hepatocytes isolated from 3-week SD rat fetuses bred were transplanted into the spleens of liver regeneration model rats with 70% partial hepatectomy. The cell cycle of the hepatocytes in the remnants liver was analyzed by flow cytometer and the density dimensions of the donor fetal hepatocytes in spleen were measured by image analysis system 7 and 30 days post-transplantation, respectively. RESULTS: Compared with the control group, the proportions of S and G 2/M cells in the remnants liver were obviously decreased ( P

Aim To investigate the influence of intranasal delivery of calcitonin gene-related peptide(CGRP)on cerebral blood supply and expression of vascular endothelial growth factor(VEGF)following experimental subarachnoid hemorrhage(SAH).Methods Wistar rats were divided into normal control group,SAH group,intranasal normal saline(NS)+SAH group and intranasal CGRP+SAH group.SAH models were produced by double injection of autologous arterial blood into cisterna magna.CGRP and NS were given by intranasal perfusion.Dynamic observations of regional cerebral blood flow(rCBF)of cerebral cortex were made using a laser Doppler flowmeter probe.On the third day after the second cisternal injection,the expression of VEGF protein in cerebral cortex was observed by immunofluorescence method combined with laser confocal microscopic observation.Results Anatomic observation revealed that SAH models were successfully manufactured.In SAH and intranasal NS+SAH groups,a drastic and persistent drop in rCBF was noted during the observed periods.The decrease of rCBF in intranasal CGRP+SAH group was slighter as compared with that in SAH and intranasal NS+SAH groups.In SAH and intranasal NS+SAH groups,increased expression of VEGF protein in cerebral cortex was observed on the third day after second cisternal injection as compared with that in normal control group.The expression of VEGF in intranasal CGRP+SAH group was more obvious than that in intranasal NS+SAH group.Conclusion Intranasal delivery of CGRP improves cerebral blood supply and promotes angiogenesis by enhancing the expression of VEGF after SAH.