BACKGROUND:Orthopedic lumbar disc herniation is a common and frequently-occurring disease which causes low back pain. Selection of surgical therapy and postoperation efficacy on lumbar disc herniation are hot focus in present study.
OBJECTIVE:To summarize current research and progress on surgical treatment of lumbar disc herniation. METHODS:The databases of PubMed and China National Knowledge Infrastructure were searched from January 1990 to January 2014 for articles on surgical treatment of lumbar disc herniation. Keywords were“Lumbar Herniated Disc;Surgical Therapy”in Chinese and English. Final y, 61 literatures were chosen.
RESULTS and CONCLUSION:There are a variety of surgical treatments for lumbar disc herniation at present, including traditional surgical procedures, lumbar fusion, percutaneous lumbar discectomy, percutaneous laser decompression, chemonucleolysis, artificial nucleus replacement, and artificial lumbar disc replacement. This study reviewed surgical methods, indication, efficacy and prognosis, and summarized the new progression of repair and therapy of lumbar disc herniation. Results found that posterior lumbar discectomy remains the most widely used and the most mature procedure, but this method has many complications and induces great trauma. Minimal y invasive treatment for lumbar disc herniation is considered to be the future direction for smal surgical trauma, less complications and fast recovery, but the surgical indications are narrow and the operation is relatively difficult, so this method stil needs more improvement and development. Lumbar disc replacement is a new treatment for lumbar disc herniation which has a good short-term postoperative fol ow-up, but the long-term prognosis stil has many problems and complications. Lumbar disc replacement needs more research and development in alternative materials and surgical approach, and should be widely applied after large-sample tests.

The anatomically and functionally complex nature of the temporomandibularjoint (TMJ) makes its reconstruction one of the most challenging tasks faced by surgeons who operate in the head and neck. TMJ prosthesis is one of the important techniques in the reconstruction of TMJ. The main indications for TMJ prosthesis include ankylosis, fractures of condylar that can't be fixed, trauma or tumor, end-stage TMJ disturbance, and TMJ dysplasia caused by Hallermann-Streiff syndrome. TMJ replacement aims to enhance the function of TMJ, alleviate pain, and prevent serious complications. TMJ prosthesis is advantageous in oral and maxillofacial surgery because it can imitate normal anatomic morphology and adhere to the host. Moreover, the use of other materials is no longer necessary and functional training can be started postoperatively at once, among others. Prosthetic materials have leading and promoting functions in the development of joint prosthesis. Good design, fit shape, and fixation are the necessary conditions for prosthesis to serve its function. Investigation of joint biomechanics is also necessary. With the rapid developments in material science, joint biomechanics, and other related subjects, TMJ prosthesis has been significantly improved in terms of its materials, design, fit shape, and fixation techniques. In addition, the development of TMJ prosthesis would expand its applications. This review intends to provide an overview about the progress and clinical application of TMJ prosthesis.
Ankylosis ; Arthroplasty, Replacement ; Humans ; Joint Prosthesis ; Reconstructive Surgical Procedures ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Adenocarcinoma, Follicular ; epidemiology ; genetics ; metabolism ; pathology ; Carcinoma, Papillary ; pathology ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Genes, ras ; genetics ; Humans ; Point Mutation ; Prognosis ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; epidemiology ; genetics ; metabolism ; pathology ; Transcription Factors

Anemia, Hemolytic ; chemically induced ; therapy ; Female ; Humans ; Paraquat ; poisoning ; Poisoning ; therapy ; Young Adult

Objective To explore the therapeutic effect, mechanism and safety of Qingrehuashi recipe in treating chronic superficial gastritis with erosion pertaining to spleen-stomach damp-heat syndrome. Methods 84 cases of chronic superficial gastritis with erosion were recruited into a control group and a treatment group randomly, with each groups containing 42 cases. The treatment group was treated with Qingrehuashi recipe, while the control group was treated with Qingweizhitong granule. Both groups were treated for 8 weeks. The clinical manifestations and signs, gastroscopic results and pathological effects were observed before and after the treatment. Results The total effective rate and curative rate in the treatment group were superior to those in the control group (P<0.05) . Conclusion Qingre Huashi recipe is effective and safe in in treating chronic superficial gastritis with erosion pertaining to spleen-stomach damp-heat syndrome. The mechanism might be related to its effects of anti-inflammation, anti-oxidation, eradicating Hp, promoting gastric motility and enhancing gastric mucosal barrier.

Purpose Placenta accreta is a rare but severe pregnancy complications, and imaging diagnosis is always difficult. This paper aims to analyze the MRI manifestations of placenta accreta, and explore its misdiagnosis reasons. Materials and Methods A retrospective study was carried out on the findings and classification of MRI plain scan and diffusion weighted imaging (DWI) scan of 18 patients with placenta accreta confirmed surgically and pathologically. Results The prenatal MRI scan reported 15 patients of placenta accreta correctly (83.33%), and missed 3 (16.67%) among which 2 were with placenta accreta and the other 1 with placenta increta. The MRI of placenta accreta presented rather thin muscular layer, discontinuous junctional zone, and some unclear boundary of placenta and uterine wall; the signal of the placenta was heterogeneous, and we could see enlarged vessels of extremely low signal on T2 HASTE and high signal on TruFISP sequences, and low signal of thick intraplacental band; moreover, hematoma with high intensity on T1WI and low intensity on T2WI could be seen. DWI demonstrated uneven intensity and dark thicker intraplacenta bands in 2 cases. Conclusion As an important clinical auxiliary tool in diagnosing placenta increta, MRI has high accuracy in the diagnosis of placenta increta and placenta percreta; however, it has rather low accuracy in placenta accreta.

Objective To investigate the pathologic bases of MRI manifestations of rabbit VX2 hepatic carcinoma.Methods 32 foci of hepatic carcinoma models in 20 rabbits VX2 were set up by implantation.Plain MR examinations in all rabbits and contrast-enhanced MR scan in 10 rabbits(15 foci) were performed 2~4 weeks after implantation.The largest transverse section specimens of all the tumors were obtained for imaging-pathology comparative study after MR scan.Results All the 32 tumors were detectable on both T1WI and T2WI.The size of the tumors ranged from 0.5 to 3.5 cm in diameter.6 foci showed homogeneous slight hyperintense on T2WI,the other 26 showed characteristic intratumoral signal intensity on T2WI,including "nodule in nodule"sign in 5 foci,"target"sign in 7 foci,and "dot and color"sign in 14 foci.The characteristic intratumoral signal showed on T2WI were pathologically testified as necrotic tumor tissue of different structures.All the 15 tumors with contrast-enhanced scan appeared annular enhancement in different degrees,slight enhancement in 6,medium enhancement in 7 and obvious enhancement in 2.The sinusoidlike vascular space between tumor cells were significantly dilated in the obvious enhancement cases,and there were many spots of necrosis in the slight enhancement tumors under microscope.Conclusion The tectology of intratumoral necrosis can be evaluated by T2WI.Enhanced degree after administration of contrast agent in the hepatic cancer in rabbit model is associated with dilating degrees of sinusoidlike vascular space and number of dotted necrosis of tumors.

[Objective]To explore the biomechanical stability of fixation with two and three cannulated compression screws in treatment of the adductive femoral neck fractures by the three-dimensional finite element analysis(FEA).[Method]Two FEA models of two screws and three screws for adductive femoral neck facture fixations were set up to investigate the simulated loading of three different conditions.[Result]At the condition of the heel touching the ground and the middle position,there was no difference in the biomechanical stabilities of the two models.However,at the condition of the tiptoe departing from the groud,the model of three screws fixation was better in torsion resistance and stretching resistance.[Conclusion]The biomechanical stability of fixation with two screws is determined by the direction of loading.Three cannulated compression screws fixation provides better biomechanical stability.

Objective To explore the effect of intrahepatic injection of liposome-mediated VEGF plasmid on ischemia-reper-fusion liver injury and its mechanism. Methods Rabbits were randomly divided into normal group, ischemia-reperfusion group and recombinant VEGF therapy group( liposome-mediated transfer of VEGF plasmid into liver via portal vein 20 min before ischemia of liver). The model of liver ischemia-reperfusion injury was established. Liver function and the activity of SOD.XO in blood were determined at the 0,2nd,6th,12th,and 24th h after operation. RT-PCR technique was applied to detect the expression level of Fas mRNA in liver tissues of every group,and flow cytometry was used to measure cell apoptosis rate at the 6th h after operation. At the 24th h after operation,all rabbits were killed and liver tissues of ischemia were taken to make pathological sections for observing the morphology and microstructure under the light microscopy and electron microscopy. ResuJts The level of ALT in recombinant VEGF therapy group was markedly reduced as compared with ischemia-reperfusion group at the 6th,12th,and 24th h after operation( P<0. 05). The activity of SOD in recombinant VEGF therapy group was significantly higher than in ischemia-reperfusion group at the 6th, 12th,and 24th h after operation. The activity of XO in recombinant VEGF therapy group was significantly lower than that in ischemia-reperfusion group at the 6th,12th,and 24th h after operation(P< 0. 05 or P<0. 01). In addition,there was significant difference in the expression of Fas mRNA and cell apoptosis rate between recombinant VEGF therapy group and ischemia-reperfusion group(P<0. 01). The injury of hepatocytes in recombinant VEGF therapy group was significantly alleviated as compared with that in ischemia-reperfusion group under the light microscopy and e-lectron microscopy. Conclusion Liposome-mediated transfer of VEGF plasmid into liver before ischemia of liver can obviously protect hepatocytes by increasing anti-oxidative ability, decreasing the expression of Fas mRNA, and finally inhibiting hepato-cyte apoptosis.

This study was to study the effect of cyclosporine A (CsA) on the expression of nitric oxide synthase (NOS) in liver cells in T cell dependent liver injury induced by concanavalin A (ConA) in mice. The results showed that there was no NOS expression in the normal murine hepatocytes. Affer ConA challenge, the expression of NOS in hepatocytes increased markedly.Moreover, the hepatocytes closer to the central vein showed stronger expression.After pretreatment of CsA, activation of T lymphocytes was inhibited and NOS expression in the hepatocytes was almost completely inhibited too.The above results suggest that an upregulation of NOS expression might be a protective response to insufficient supply of blood and oxygen as a result of ConA induced liver injury, and inhibition of the NOS expression by CsA might be associated with inactivation of T lymphocyte.