[Objective]To evaluate the clinical efficacy of posterior pedicle screw instrumentation followed by anterior debridement and bone grafting through the lateral edge of the rectus abdominal muscle and retroperitoneal approach for the treatment of tuberculosis of the lower lumbar spine. [Methods]From June 2002 to January 2007,27 patients suffering from lower lumbar tuberculosis were treated with this technique.[Results]The surgical average time and amount of bleeding was 4.3 h and 438 ml respectively.The length of anterior incision was 5~7 cm.The average time and the amount of bleeding were 21 min and 48 ml respectively during the anterior lesion exposure.The follow-up period were 12~37 months,mean 17.3 months.The average preoperative,immediate postoperative,and final follow-up local lordotic angles of the affected segments were-2.1??4.0?,4.9??1.4?,3.7??3.0?.All patients had healed of disease and there was no recurrence at final follow up.Bony fusion was obtained in all patients.[Conclusion]Anterior exposure through the lateral edge of the rectus abdominal muscle and retroperitoneal approach is simple and less invasive.The spinal stability is achieved through short-segment pedicle screw fixation while reducing the sacrifice of additional motion segments.This technique is safe and effective for the treatment of tuberculosis of the lower lumbar spine.

Objective To analyze the incidence and possible etiological factors of hyponatremia after acute cervical spinal cord injury (CSCI),and evaluate the effect of severity of CSCI,age,sex and injured segment on hyponatremia.Methods From June 2005 to March 2011,a series of patients with CSCI caused by cervical vertebras trauma were treated in our department.Except patients combined with craniocerebral injury or chronic diseases,other patients were divided into three groups:complete CSCI group,incomplete CSCI group and no neurological disorder group.Concentration of natrium in blood in all patients was analyzed respectively.Results All 102 patients (83 males,19 females) were selected with an average of 45.6years old.There were 23 patients with complete CSCI,60 with incomplete CSCI and 19 with no neurological disorder.Hyponatremia was found in 15 patients in complete CSCI group,23 patients in incomplete CSCI group and 1 patient in no neurological disorder group.The incidence of hyponatremia was significantly different between three groups,among which the complete CSCI group had the highest incidence.Multiple linear regression analysis showed hyponatremia was obviously correlated with the injury degree of spinal cord,but not correlated with the age,sex and injury segment of the patients.Conclusion Hyponatremia is a common complication in patients suffered from CSCI.Although the balance of natrium in blood is very complicated and influenced by many factors,autonomic nerve system and neuroendocrine system dysfunction,and hemodynamic changes after CSCI may play a key role in happening of electrolytical abnormality.

Objective To investigate the change and effect of SSeCKS(src suppressed c kinase substrates)in the activation of hepatic stellate cells(HSCs).Methods HSCs were isolated from normal rats,the change of SSeCKS mRNA expression on HSCs culture in vitro was determined using real.time PCR.protein level was determined by Western blot and immunofluorescence methods.A rat model of liver fibrosis was established.The expression and location of SSeCKS and α-SMA(α-smooth muscle actin)in liver tissues were detected by immunofluorescence methods.Results SSeCKS mRNA expression WaS loW in freshly isolated HSCs cell and the expression increased in activated HSCs in vitro.In liver fibrosis tissue,the number of SSeCKS-positive cells was increased and these cells were distributed along the sinusoids which also contained α-SMA positive cells.Conclusion The expression of SSeCKS was increased in activated HSCs in vitro.Therefore.SSeCKS may be involved in the liver inflammation and fibrosis.

Objective To investigate the effects of current major management strategies on early survival of patients with severe injury of cervical spinal cord. Methods A retrospective analysis was done on 532 patients with severe injury of cervical spinal cord (American Spinal Injury Association Grades A and B). The correlations of the early survival and major treatment measures, post-injury temporary immobilization of neck, operation, tracheotomy, systemic nutritional support, administration of glucocorticoid, were analyzed by Binary Logistic Regression. The problems related to the major treatment measures were also analyzed.Results 438 cases survived within 1 month. There was a positive correlation between the early survival and operation and nutritional support. There was a negative correlation between the early survival and tracheotomy.There was not any significant correlation between the early survival and the other 2 measures. The early sur-vival rate for patients of operation was 93.5%, for those without operation was 32. 7%, for those of goodnutrition was 97.8%, for those without good nutrition was 66. 7%, for those of tracheotomy was 58.1%, and for those without tracheotomy was 87.5%. Conclusions For patients with severe injury of cervical spinal cord, active operation and fine systemic nutritional support may increase early survival rate, undue tra-cheotomy may increase the risk of early death, and glucocorticoid may not have an effect on improvement of early survival rate.

Objective 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG are both radiopharmaceuticals for inflammation and infectious disease imaging.It was reported that99Tcm-ciprofloxacin (Infecton)Was able to distinguish inflammation from infection.while 99Tcm-HIgG was a nonspecific agent.The study Was designed to compare the in vivo characteristics between 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG in rabbit model of inflammation.Methods Eight rabbits were grouped as inflammation model(the first group).infection model(the second group),concomitant inflammation and infection model(the third group),and control(the fourth group)groups.A total of 185 MBq(0.5 m1)99Tcm-ciprofloxacin(Infecton)Was administered intravenously to each rabbit.a serious dynamic images were acquired till 24 h post-injection.Repeated examination with99Tcm-HIgG was carried out 2 d later.Resuits 99Tcm-ciprofloxacin(Infecton)scan was negative in the inflammation models and controls.and was positive in the infection models.In the third group99Tcmciprofloxacin(Infecton)showed infection focus in the left thigh but negative uptake at inflammation focus in the right thigh.99Tcm-HIgG scan were positive in all models.The optimal image time for99Tcm-ciprofloxacin(Infecton)was 3 h after administration.but positive image could still be observed 24 h later.Conclusion 99Tcm-ciprofloxacin(Infecton)appears to specifically accumulate in the infective lesion.

The aerolysin genes (aerA) of BZ and NK isolates were cloned and sequenced. The sequence analysis showed that the partial aerA of BZ and NK isolates consisted of 1393 bp, encoding a protein of 464 amino acids. The similarity of nucleotide and amino acid sequences of aerA between BZ and NK isolates was 97.6% and 98.3% respectively. The nucleotide sequence of aerA of BZ strain exhibited 71.6% to 97.5% homology with other Aeromonas isolates, and the amino acid sequence exhibited 68.0% to 98.9% homology. The phylogenetic tree based on aerA nucleotide sequences from Aeromonas isolates was constructed with neighbor-joining method. It showed that there were three branches of aerolysin genes, and a close relation- ship among Aeromonas hydrophila isolates which were clustered into the same branch.

BACKGROUNDPhacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts.

METHODSIn this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch & Lomb Millennium phacoemulsifier with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height, 85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used.

RESULTSThe mean ultrasonic power was 14.7% (range 9% to 19%), ultrasonic time was 1.98 minutes (range 1.55 to 3.18 minutes). At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% (range 8% to 17%). There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperative or postoperative complications were noted.

CONCLUSIONSThe peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.

Background and purpose:Nab-paclitaxel (Abraxane) is an albumin-bound form of paclitaxel that utilizes the natural properties of albumin to improve paclitaxel delivery to the tumor. It has recently been approved for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within short time after adjuvant chemotherapy. The purpose of this study was to evaluate the efifcacy and safety of albumin-bound paclitaxel in patients with aggressive and refractory metastatic breast cancer (MBC).Methods:A total of 58 patients with MBC were enrolled into this study from Jul. 2009 to Jan. 2014. All patients received albumin-bound paclitaxel-based chemotherapy. The adverse reactions were evaluated every cycle, and the short-term response was evaluated every two cycles. The patients were followed-up, and the survival was analyzed.Results:58 patients with refractory MBC were evaluable for response, 67.2% of patients received multiple line (≥3 lines) chemotherapy, 32.8% of patients with first and second line of chemotherapy were involved metastasis within one year after adjuvant chemotherapy, 84.5% of patients with visceral metastasis and 93.1% with prior taxane treatment. The objective response rate (ORR) was 13.8%, and disease control rate (DCR) was 60.3%, the median progression free survival (PFS) was 4.0 months, and the overall survival (OS) was 10.1 months. For 23 patients with triple negative breast cancer, ORR was 13.0% and DCR was 56.5%, the median PFS was 4.1 months, and OS was 6.6 months. The main toxicity was myelosuppression (grades 3 and 4 neutropenia, anemia and thombocytopenia were seen in 34.5%, 12.1% and 6.9% of patients, respectively), gastrointestinal reactions, sensory neuropathy, myodynia/arthragia, fatigue, alopecia and so on.Conclusion:The albumin-bound paclitaxel-based chemotherapy can be used in aggressive and refractory MBC. It also showed antitumor activity in taxanes-resistance patients and triple negative patients with good safety and tolerance.

Babesia microti is one of the most common causative agents of babesiosis. A sensitive and rapid detection is necessary for screening potentially infected individuals. In this study, B. microti cytochrome c oxidase subunit I (cox1) was selected as the target gene, multiple primers were designed, and optimized by a recombinase-aided amplification (RAA) assay. The optimal primers and probe were labeled with fluorescein. The sensitivity of fluorescent RAA (fRAA) was evaluated using gradient diluents of the cox1 recombinant plasmid and genomic DNA extracted from whole blood of B. microti infected mice. The specificity of fRAA was assessed by other transfusion transmitted parasites. The analytical sensitivity of the fRAA assay was 10 copies of recombinant plasmid per reaction and 10 fg/µl B. microti genomic DNA. No cross-reaction with any other blood-transmitted parasites was observed. Our results demonstrated that the fRAA assay would be rapid, sensitive, and specific for the detection of B. microti.

Objective To observe the expressions ofinterleukin-17A (IL-17A) and transforming growth factor β (TGF-β) in the peripheral brain tissue of nidus after microsurgical resection of brain arterivenous malformations (AVM),and their significance.Methods We prospectively chose 25 patients with AVM; 12 of them were performed endovascular embolization and then microsurgical removal (Group A),and the other 13 were performed microsurgical removal only (Group B).Another 6 patients with traumatic brain injury and hypertensive cerebral hemorrhage that needed internal decompression were used as controls.The expressions of IL-17A and TGF-β in these brain tissues were detected by immunohistochemistry and RT-PCR.Results The protein and mRNA expressions of IL-17A in Group A and B were significantly increased as compared with those in the controls (P＜0.05);the protein and mRNA expressions of IL-17A in Group A were significantly decreased as compared with those in Group B (P＜0.05).The protein and mRNA expressions of TGF-β in Group A and B were significantly decreased as compared with those in the controls (P＜0.05); the protein expression of IL-17A in Group A was not significantly increased as compared with that in Group B (P＞0.05); the mRNA expression of IL-17A in Group A was significantly increased as compared with that in Group B (P＜ 0.05).Conclusion The increased expression of IL-17A might be associated with the growth and pathologic process of AVM; the increased expression of TGF-β might inhibit the inflammatory reaction after embolization.