Objective To explore preliminary clinical results of a new anatomical shape allogeneic bone posterior lumbar fusion cage. Methods Follow-up patients used the allogeneic bone posterior lumbar fusion cage and use imaging methods and clinical score (VAS, ODI) to evaluate the patients′ clinical efficacy. Results 14 patients were followed up for 6 months or more , with an average follow-up time of 9.7 months , mean preoperative VAS 6.8 ± 1.1, ODI 32.7 ± 4.5. The mean preoperative disc height was (9.7 ± 2.0) mm and the average intervertebral height of 3 days post operation was (13.2 ± 1.7) mm. All patients got bony fusion in 6 months post operation, pain and function scores improved significantly compared with the pre-operation: VAS 2.4 ± 0.8 (P =0.000), ODI 9.8 ± 2.5 (P = 0.000), the average intervertebral height was (13.1 ± 1.7) mm (P = 0.000). The average was VAS 2.1 ± 0.1 (P = 0.000), average ODI was 8.9 ± 0.9 (P = 0.000) at last follow up. Average of intervertebral height was (13.0 ± 1.8) mm, no significant difference compared to three days after surgery (P=0.831). No serious complications and deep surgical site infection was observed. All implants were found no fragmentation, shift, cutting boards, and obviously sinking. Conclusion The anatomical shape allogeneic bone posterior lumbar fusion device is suitable for posterior lumbar interbody fusion , advantages of high fusion rate , satisfactory clinical results in the initial clinical trials , but its long-term efficacy requires further observation.

Objective To evaluate the prognostic value of the neuron-specific enolase ( NSE ) and bispectral index ( BIS) in patient with mild therapeutic hypothermia ( MTH) after cardiopulmonary resuscitation ( CPR ) .Methods Forty-six patients with restoration of spontaneous circulation ( ROSC ) after CPR were treated with MTH.The BIS values were recorded and the serum NSE was measured at the following times:24 h, 48 h, and 72 hours after ICU admission.Neurological outcome was classified according to the Pittsburgh cerebral performance category ( CPC 1 to 5) at 3 months after ICU discharge.Results Fourteen patients had a good neurological outcome with CPC score 1-3, and thirty-two patients had a poor neurological outcome with CPC 4-5 at 3 month.Compared with good outcome group, the NSE values were significantly higher in the poor outcome group on day 2 and day 3 after admission [48 h: (90.1 ±42.7) ng/mL vs.(33.2 ±17.5) ng/mL;72 h: (95.4 ±37.0) ng/mL vs. (29.2 ±17.0) ng/mL, P<0.05].NSE increased markedly in the poor neurological outcome group at 48h and 72h, and decreased significantly in the good group at the same time [△NSE 24 h-48 h: (37.3 ±28.7) ng/mL vs.(-10.7 ±12.1) ng/mL; △NSE 48 h-72h: (5.3 ±13.2) ng/mL vs.(-4.0 ±4.5 ng/mL), P<0.05].Over the 72 h of monitoring, the mean BIS values were lower in the poor outcome group compared to the good outcome group at 48 h [ (39.2 ±24.1) vs.(78.0 ±12.4); 72 h: (45.7 ±26.4) vs.(89.0 ±7.3), P<0.05].Conclusions The values of NSE and BIS were effective prognostic indicators for the neurological outcome of patients with MTH after CPR.

Objective To evaluate the association between bradycardia and neurological sequel in patients with restoration of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR) during targeted body temperature management (TTM).Methods Forty-three unconscious patients with ROSC after CPR were treated with TTP.The patients were cooled with therapeutic hypothermia to body temperature target range (32-34°C) after cardiac arrest and divided into bradycardia and control groups depending on the lowest heart rate less than 50 beats/min and more than or equal to 50 beats/min respcetively at that time.The bispectral index (BIS) and the neuron-specific enolase (NSE) values were respectively recorded at the following intervals,0h (h0)、24h (h24)、48h (h48)、72h (h72) after ICU admission.Neurological outcome was defined according to the Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge.Results Compared with the control group,during TTM the bispectral index levels were significantly higher in the bradycardia group at h0,h48,h72 after admission,(h0 bradycardia group 73.0 ± 12.3;control group 58.0 ± 18.6,P ＜0.01)、(h48 bradycardia group 71.4 ± 21.2;control group 46.3 ± 18.9,P ＜ 0.01)、(h72 bradycardia group 78.6 ± 24.6;control group 51.8 ± 24.1,P =0.01).The neuron-specific enolase level in bradycardia group was significantly lower than that in control group on day3 (118.8 ± 118.8 ng/mL vs.248.3 ± 191.9 ng/mL,P =0.02).The level of CPC in the bradycardia group was significantly higher than that in the control group (P =0.046).Conclusions Patients with bradycardia during TTM had favorable neurological outcome,which could provide evidence for clinical treatment and prognostic evaluation of the patients.

Objective To explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K.pneumoniae) lower respiratory tract infection(LRTI) in children.Methods Clinical data of 107 children with K.pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively.Results 62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter.All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases(36.45%) had complications involving two systems, 5 cases(4.67%)had complications involving three systems,47 cases (43.93%) met the diagnostic criteria of severe pneumonia.43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition.Children with imipenem-resistant bacteria infection were more prone to develop extrapulmonary complications than those with non-resistant pathogenic infection.The resistance rate of K.pneumoniae to amikacin was the lowest(9.35%).90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died.Conclusion Children aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

Objective To explore the clinical characteristics and prognostic factors of breast carcinosarcoma.Methods Clinical data of 37 breast carcinosarcoma patients treated at Tianjin Cancer Hospital from 1974 to 2014 was analyzed retrospectively.Kaplan-Meier unvariate analysis was used to calculate the survival rate and compare the survival rates.Multivariate factors for survival were analyzed by COX proportional hazards regression model.Results 37 cases of breast carcinosarcoma were all female.The median age was 55 years.Among them 31 cases complained for painless mass,six cases had breast mass with skin ulceration.21 cases were three-negative breast cancer.Ten cases had axillary lymph node metastasis,ten cases had distant metastasis.The 5-year survival rate was 62.3％.Unvariate analysis showed that axillary lymphnodes metastasis (P =0.045) and therapeutic schedule (P =0.016) significantly influenced the oulcome of the patients.COX multivariate analysis validated that the therapy modality was an independent prognostic factor for breast carcinosarcoma(P =0.041).Conclusions Breast carcinosarcoma is rare and has a poor prognosis.ER,PR and HER-2 expressions in most cases are negative.If there is axillary lymph node metastasis,the prognosis is poor.A reasonable and comprehensive treatment can improve the prognosis.

AIM: To compare the effectiveness of botulinus toxin of type A and complete resection of the periorbital muscle on idiopathic blepharospasm.
● METHODS: Patients with idiopathic blepharospasm and having undergone either of two procedures from Dec. 2010 to Jun. 2015 were selected ( 60 patients ) . Among them, group A (30 patients, 60 eyes) underwent botulinus toxin of type A, group B (30 patients, 60 eyes) underwent complete resection of the periorbital muscle.
●RESULTS: ln group A, the patients with complete response, obvious response, partial response, and no response were 36(60. 0%), 20(33. 3%), 2(3. 3%) and 2 (3. 3%) cases respectively. ln group B, the patients with complete response, obvious response, partial response, and no response were 16(26. 7%), 24(40. 0), 12(20. 0%) and 8 ( 13. 3%) cases respectively. The difference was statistically significant ( Z = - 2. 968, P = 0. 003 ). The relapse rate of group A and group B were 93. 3% and 20. 0% after 6mo, the difference was statistically significant (χ2=32. 851, P<0. 001).
●CONCLUSION: The botulinus toxin injection of type A is effective for idiopathic blepharospasm. But recurrence rate is high after 6mo. Complete resection of the periorbital muscle have long-term efficacy for idiopathic blepharospasm. It′s a supplementary therapy after idiopathic blepharospasm recurrence.

The number of projects and the amount of sponsoring funds have been increasing during the past years.Conventional research branches are respiratory tumor and digestive tumor.Emerging research branches are lung transplantation and lung preservation.Underdeveloped research branches are acute lung injury and acute respiratory distress syndrome and thymic tumor.The position and academic impact of domestic thoracic surgery has been more valuable with the increasing number,quality and achievements of SCI papers.Therefore,international cooperation and megamergers should be encouraged and more attention should be paid to the censorship,implementation and achievements to optimize the value of projects.The aim of this article is providing important information on projects sponsored by National Nature Science Foundation of China(NSFC) in the field of general thoracic surgery,promoting the development of thoracic surgery of China.

Objective To study hcpatitis B virus (HBV) reactivation and related risk factors for ≤5 cm hepatocellular carcinoma (HCC) by radiofrequency ablation (RFA) or hepatic resection.Methods From Sep 2006 to Jan 2013,193 patients received hepatectomy and 146 patients received RFA.Univariate and multivariate logistic regression analysis was used to assess risk factors.Stratified x2 test for HBV reactivation,Unpaired student's t-test for CD4 +,CD8 +,CD4+/CD8+ and NK cell proportions.Results (1) Antiviral therapy,Child-Pugh grade,vascular invasion and treatment modality were significant risk factors of HBV reactivation (P ＜ 0.05).(2) HBV reactivation was lower in patients receiving antiviral therapy than those who did not (16/181 vs.25/158,x2 =3.869,P =0.049),the reactivation in hepatectomy group was higher than RFA group in those not using antiviral therapy (20/92 vs.5/66,x2 =5.788,P =0.016),but the difference was not significant in the antiviral therapy patients (10/101 vs.6/80,x2 =0.319,P =0.572).(3)CD3+,CD4+,CD4+/CD8+ and NK cell proportions after 7 days treatment decreased in different degree for both hepatic resection and RFA group with or without antiviral therapy (P ＜0.05).For patients who did not received antiviral therapy,the proportions of RFA after 7 days treatment were higher than the hepatic resection group (P ＜ 0.05).Conclusions Compared with ≤5 cm carcinoma treated by RFA,hepatic resection decreased the proportions of immune cells,preoperative antiviral therapy relieves immune suppression,decreases the incidence of HBV reactivation.

Objective To analyze the indications,techniques of MR-guided localization and the imaging features of breast lesion.Methods Hook wire localization was performed in 43 patients whose lesions were only detected by MRI,based on a 1.5 T MR scanner and a special MR biopsy positioning frame.The feasibility of operation and accuracy of localization were explored.Lesion features and pathologic findings were analyzed using Fisher exact test.Results A total of 37 patients (86.0％) with 38 lesions underwent MR-guided localization.Of the 6 patients canceled,the lesions were not obvious in 4 patients,and the positioning was difficult in 2 cases.Of the 38 lesions,17 were masses,20 were non-mass enhancement lesions,and one lesion was undetermined enhancement.There were 11 (28.9％) malignant lesions.The distribution of internal enhancement pattern was different between benign and malignant non-mass lesions (P =0.028),while the other morphological features between benign and malignant were not significantly different (P ＞ 0.05).Conclusions MR-guided localization provides an accurate and safe method for localizing the suspicious lesions on MRI.The morphological findings of these lesions are not characteristic for the differentiation of benign and malignant lesions.

Objective To investigate the effect of 620 nm red light on chondrogenic differentiation in rat precartilaginous stem cells (PSCs). Methods Rats' PSCs were isolated and purified using magnetically activated cell sorting and cultured in vitro.The PSCs were exposed once to 620 nm wavelength red light from a light-emitting diode (LED) with an irradiation energy of 0.5 J/cm2,1 J/cm2,2 J/cm2 or 4 J/cm2.Any effect was confirmed by Alcian blue staining,immunohistochemistry and observing histomorphological changes under a light microscope,as well as detection using a reverse transcription polymerase chain reaction (RT-PCR). Results After being induced for 14 d,the PSCs exhibited polygonal and round shapes. Alcian blue and type Ⅱ collagen immunohistoehemistry staining showed positive results,but the control group had no significant change.RT-PCR showed that the mRNA expression of Sox9 and type Ⅱ collagen increased significantly compared with the control group. Conclusion Low energy 620 nm red light can enhance chondrogenic differentiation in PSCs significantly.