AIM:Spondylolisthesis is a common spinal disease for adults but rarely found in children.In this study,the treatment effect of spondylolisthesis in 7 children with posterior pedicle screw system after 1 year was explored.METHODS:①Eight children patients with spondylolisthesis treated in Shengjing Hospital of China Medical University between January 1996 and December 2006 were selected including 4 males and 4 females.The average age was 12.25 years(range,8-14 years).According to Meyerding classification,7 cases were of stage Ⅰand one of Ⅳ.②Texas Scottish Rite Hospital(TSRH) posterior pedicle screw system was provided by Wego Ortho Co.,Ltd.,GB1Z type,titanium,No.200511028009.Of the 8 cases,4 were treated by TSRH posterior pedicle screw system,3 were treated via a Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion,and 1 was not treated by operation.The informed consent of treatment was obtained from the patients.③The changes in the spinal radioactive imaging before and after operation,and the material and host biocompatibility were observed.RESULTS:①Seven of 8 cases were followed up.The mean time of follow-up was 56.6 months with a range from 13 to 111 months.②Three of 4 cases treated by TSRH were vertebral completely reduction with the stability of instrumentation about 75%(3/4),and the other one was partly reduction(about 85%).One person developed the progress again in the X-ray films at three weeks after operation.Three cases treated by Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion healed well without the recurrence of lumbosacral spondylolisthesis and nonunion.CONCLUSION:TSRH is an efficient and safety option for the treatment of spondylolisthesis in children.

OBJECTIVE:To establish quality control system by using modern scientific idea and advanced method in in?patient pharmacy.METHODS:Under the situation o f running authentication of ISO9001quality control system in our department,inpatient pharmacy should take the patients as focus to offer good and normative services to patients and clinical departments and continue to make our work better.RESULTS&CONCLUSION:Implementation of ISO9001quality control system has standardized the management of quality of inpatient pharmacy as well as increased the patients'satisfaction.And satisfactory social and economical benefits have been obtained and self-perfect and continuous improvement have been realized in the inpatient pharmacy.

Objective To define the normal reference values of acetabular index and Sharp angle through 2333 standard anterior-posterior pelvic radiographs. Methods In our study, 2333 normal anteriorposterior pelvic radiograph images with standard exposure were selected. All the images were diagnozed normal by two radiologists and two pediatricians according to the criteria of T(o)nnis. All subjects were without any neuromuscular diseases and congenital defoemity. The acetabular index was measure in the subjects between age 0 to 10 years, and the groups were divided monthly within 1 year and yearly between 1 to 10years. The Sharp angle was measure in the subjects after 10 years, and the groups were divided yearly in adolescence and decadely in adults. Normal values of each age groups and the correlation charts were completed according to statistical analysis. Results The mean acetabular index was 28.39° in neonates followed by a steep decrease in the first three months after born. It decreased to 22.17°in the 1st year, 12.80°in the 10th years and then kept constant. Acetabular index of the female was generally 1°-2°larger than that of the male with statistical significance. The mean Sharp angle was 46.72°in the 10th years, which decreased to 39.10°in the 18th years and 35.69°in elderly people. Another declination was observed after age 40.Generally no gender difference was observed. Conclusion Acetabular index and Sharp angle vary with age.They reflect a dramatic morphological change in the acetabulum before adulthood and stay constant afterwards. Gender difference is obvious in many age groups but not all. Normal reference ranges of both gender at all age groups should be considered in clinical evaluation.

Objective:To investigate the ultrasonographic characteristics and risk factors of breast cancer internal mammary lymph node (IMLN) metastasis.Methods:A retrospective analysis of 296 first diagnosed breast cancer patients in the Fourth Hospital of Hebei Medical University from March 2010 to May 2020. IMLN was divided into metastatic group (236 cases) and non-metastatic group (60 cases) based on pathology. Chi-square test and independent sample t test were used to analyze the ultrasound characteristics of IMLN metastasis and factors related to metastasis. ROC curve analysis of IMLNs were plotted to obtain the diagnostic thresholds and their sensitivity and specificity.Univariate and multivariate Logistic analysis was used to analyze the risk factors of IMLN metastasis. Results:①The appearances of IMLN in ultrasound were normal type, thickened-cortex type, unclear hilus structure type and thickened-nodular soft tissue type. ②In the two groups, the differences in IMLN long diameter, thickness diameter, number, and lymphatic hilum structure type were statistically significant (all P<0.05), and there were no significant differences in IMLN long diameter/thickness diameter and IMLN blood supply (all P>0.05). ③The long diameter threshold of IMLN for diagnosis of metastasis was 10.5 mm, the are under the ROC curve(AUC) was 0.825, with sensitivity of 58.5% and specificity 93.3%; thickness and diameter threshold was 4.5 mm, AUC was 0.790, with sensitivity 66.9% and specificity 75.0%. The sensitivity and specificity of the diagnosis of long-diameter combined structure type were 56.3% and 93.3%, respectively; the sensitivity and specificity of the diagnosis of thick-diameter combined structure type were 64.8% and 81.7%, respectively. The cortical thickness threshold was 1.9 mm, and the diagnostic sensitivity and specificity were 91.9% and 86.7%, respectively. ④The risk factors of IMLN metastasis inculded univariate analysis showed tumor length, tumor volume, axillary lymph node long diameter, axillary lymph node metastasis, and clavicle lymph node metastasis. There was a statistically significant difference in the pathology of the lower lymph nodes between the two groups ( P<0.05). Multivariate analysis showed that the long diameter of the tumor and the metastasis of the axillary lymph nodes were independent risk factors of IMLN metastasis. Conclusions:The metastatic IMLN mostly manifest as no lymphatic hilum structure or cortical thickening (≥1.9 mm), and multiple IMLN can help diagnose metastasis.Ultrasound can better assess breast cancer IMLN metastasis, and the diagnostic efficiency of IMLN long-diameter combines structure type is higher.Independent risk factors for IMLN metastasis include tumor size and axillary lymph node metastasis.

Objective· To compare the impacts on clinical efficiency and safety between 0.014 inch Synchro microwire and Transend microwire used during mechanical thrombectomy for acute ischemic stroke (AIS) caused by large artery occlusion.Methods· Forty-six patients undergoing mechanical thrombectomy with stent retrievers between October 2012 and January 2016 were included,who were classified into Synchro group (21cases) and Transend group (25 cases).The clinical outcome,procedure time,and safety were analyzed and compared between two groups.Results· The recanalization rates were similar between two groups (P=0.600),but time from puncture to vascular recanalization of Synchro group was much shorter than that of Transend goup (48.88 min vs 82.33 min,P=0.001).The rates of functional independence (modified Rankin scale score ≤ 2) were similar between two groups (P=1.000).There was no significant difference of the rates of post-procedure subarachnoid hemorrhage (PSAH) between two groups (P=1.000).However,there were two cases that had fatal subarachnoid hemorrhage with intracranial hematoma in Transend group,while there was only one case of mild subarachnoid hemorrhage who recovered well in Synchro group.Conclusion· Compared with Transend microwire,Synchro microwire can significantly shorten the procedure time of mechanical thrombectomy,and the risk of fatal subarachnoid hemorrhage is rather small.

Bone Diseases, Developmental ; surgery ; Female ; Femur ; pathology ; surgery ; Fibrosis ; surgery ; Humans ; Middle Aged

We retrospectively analyzed the clinical manifestations,treatments and prognosis of infective endocarditis (IE)associated with renal lesions in children.There were 23 confirmed IE cases who were admitted to the Capital Institutes of Pediatrics from 1992 to 2012.There were 6 cases (26％) with renal lesions.Renal lesions included asymptonatic microscopic hematuria(1 case),asymptomatic proteinuria (1 case) and acute nephritic syndrome (4 cases).There were 3 cases of acute renal injury (AKI) resulted from nephritis accompanied with acute heart failure.The serum level of C3 was lower in patients with renal lesions than patients without renal lesions (P ＜ 0.05),but the clinical manifestations,physical signs and other laboratory findings were the same.Patients of both groups were treated with antibiotics.All patients were recovered and discharged.The average hospital days were (39.2-± 15.2)days for patients with renal lesions and (34.9-± 19.2) days for patients without renal lesions (P ＞ 0.05).Renal lesions secondary to IE are relatively common in IE patients in children.Most of renal lesions can be improved by effective antibiotics.Prognosis of those patients accompanying with AKI is bad.

Neurofibroma is an autosomal dominant genetic disease which is originated from the abnormal differentiation of neural crest cells and would cause system damage.NF can occur at most organs in the body,while it is rarely seen in the common bile duct.In February 2007,1 old patients with NF was admitted to the Lishui Central Hospital of Zhejiang Province.The results of preoperative magnetic resonance cholangiopancreatography (MRCP) revealed that the common bile duct was slightly dilated,and the diameter of the common bile duct was 1.2 cm.A nodular short T2 signal lesion was detected at the middle part of the common bile duct with the size of 1.4 cm × 1.6 cm.The results of intraoperative rapid frozen section pathological examination showed that the lesion was cholangiocarcinoma,then cholangiocarcinoma resection + biliojejunal Roux-en-Y anastomosis was applied to the patient.Postoperative pathological examination confirmed that the lesion was neurofibroma.The patient was followed up for 7 years and died of pulmonary infection in June 2014.The clinical presentation of neurofibroma of the common bile duct is untypical.Space-occupying lesions detected in the patients with history of bile duct injury or operation should be considered to be diagnosed as neurofibroma.Special attention should be paid to the accuracy of the results of rapid frozen section pathological examination in order to avoid missdiagnosis.

ObjectiveTo investigate the relationships between T and NK cells in peripheral blood and the relapse or metastasis of malignant tumors.MethodsFlow cytometry was used to test the percentages ofT and NK cells in peripheral blood of 48 malignant tumor patients with relapse or metastasis (relapse or metastasis group) and 48 malignant tumor patients without relapse or metastasis(control group).ResultsCompared with control group,the ratio of Th/Ts decreased,CD4+/CD25+ raised and the activities of NK cells decreased in relapse or metastasis group (0.95 ±0.52 vs.1.35 ±0.43,7.15 ±3.81 vs.6.01 ±2.67,0.2053 ±0.1135 vs.0.2501 ±0.0745)(P＜0.01 or ＜0.05).ConclusionsTesting the T and NK cells in peripheral blood of malignant tumor patients regularly can know their immune status and find the relapse or metastasis early.It is easy and useful in patients' follow-up.

Objective To investigate the inlfuence of overexpression of miR-26b on the secretion of adipokines dur-ing human adipocyte differentiation. Methods Human preadipocytes were infected with the hsa-miR-26b over-expressing lentivirus and were induced to differentiate, and then the levels of adipokines (IL-6, leptin, resistin, TNF-α) at different time points during differentiation were measured by ELISA. Results Compared with control group, decreased secretions of both IL-6 and leptin, and increased secretion of resistin were found during the differentiation of human adipocytes in miR-26b overexpressed group. However, the secretion of TNF-αwas not measured in both groups. Conclusion The miR-26b can improve the inlfammation and insulin resistance of human adipocytes, which will provide potential targets for obesity treat-ment.