Objective In order to find the best methods for treatment of lumbar intervertebral disc herniation through posterior approach microendoscopic discectomy. Methods The approach of operation by lamina arcus vertebrae space was used to remove ligamentum flavum not to removed lamina arcus vertebrae and other tissue in lateral recumbent position. Extraction of lumbar interverebral disc herniation was used in 113 cases. Results A follow-up study was performed after operation, ranged from 6 to 24 months with a mean duration of 12 months. According to Nakai standard, there were 107 cases scored "excellent" and 6 scored "good". Conclusion Microendoscopic discectomy by the approach of lamina arcus vertebrae space caused less injury and bleeding, and was safe for both surgery and anesthesia. It achieved successfully without affecting the spinal stability.

Objective To evaluate the effectiveness of Moss Miami pedicle sc re w system in the treatment of thoracolumbar burst fractures. Methods A total of 2 7 cases of thoracolumbar burst fractures were operated on with Moss Miami pedicl e screw system through posterior approach to provide spreading, reduction and fi xation. The bilateral posterolateral bone-graft spinal fusion was also done at the same time. Results The 27 patie nts were followed up for 6 to 30 months. The heights of compressed vertebral bod y and the cross spinal canal were significantly increased after treatment (P

BACKGROUND: The effect of the treatment of long tubular bone defect by free vascularized fibular graft, especially when combined with monitoring island skin flap is definitely reliable. However, there is still the possibility of broken fibular graft with single fibular graft for repairing the long loading tubular bone.OBJECTIVE: To investigate the clinical effect on the treatment of long femoral bone defect by combinatorial fibular graft with monitoring island skin flap.DESIGN: Before and after self-controlled observation.SETTING: Department of Orthopaedic Spine Surgery, Guangzhou People's HospitalPARTICIPANTS: Totally 14 patients who wer treated for long femoral bone defect in the Department of Orthopaedic Spine Surgery were recruited between July 1995 and November 2003. Locus: distal part of the femur,5cases; middle part of the femur, 9cases.The length of bone defect was 6 to 28 cm.INTERVENTIONS: There were 7 cases of free vascularized bi-fibular graft transplantation with monitoring island skin flap. There were 7 cases of free vascularized fibular graft centralized with large segmental allograft.Monitoring island skin flap was 3 cm×5 cm, sectioned fibular was 16 to 32cm. Dry frozen bone of allograft was 12 to 28 cm. The wound and island skin were detected postoperatively.MAIN OUTCOME MEASURES: The living condition of bi-fibular graft or binding composite allograft with skin flap, morphology change of transplanted bone and loaded walking ability in patients with bone defect after operation.RESULTS: Totally 14 patients entered the result analysis. Seven cases in bi- fibular group were followed up for 3 years and 7 patients in the centralized graft group were followed up for 1 year. Fourteen cases detected by monitoring island skin flap all survived. One case in the centralized graft group presented yellow exudates 3 months after operation, and then the graft bone was taken out. Follow-up of the rest 6 patients showed that transplanted fibular bone was closely connected with allograft. The thickness of the transplanted bone was increased, shaped and similar with the diameter of the femur at the receptor. Patients in the two groups could walk with loading without walking stick. Transplanted bone has no fracture.CONCLUSION: Transplantation of free vascularized bi-fibular graft transplant or free vascularized fibular graft monitoring island skin flap binding to large segmental allograft can increase its structural strength through hypertrophy, decrease or avoid fracture of the transplanted graft fibula.

Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out ( PiCCO ) .Methods 42 septic shock patients were divided into the PiCCO group(n=26) and the control group(n=16).All patients measured heart rate(HR),mean artery pressure(MAP), central venous pressure(CVP);CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [(101.3 ±7.8) and (119.4 ±7.2),t=-7.520,P<0.05;(71.8 ±7.6) and (51.5 ±8.9),t=7.873,P<0.05;(17.0 ±3.4) and (22.7 ±4.1),t=-4.978,P>0.05;(53.6 ±11.5) and (-16.5 ±5.2),t =9.283,P <0.05].There were no differences in 28-Day mortality between two groups (t =-2.162,P>0.05),but ICU hospitalization time decreased in PiCCO group [(13.8 ±2.6) and (23.3 ±2.2),t=-5.075,P<0.05].Changes in GEDVI was positively correlated with Changes in CI (r=0.799,P<0.05),while changes in CVP was poorly correlated with CI (r=-0.446,P>0.05).Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression .

Objective To observe the effect of rapid reduction of physical activity on bone mass (BMC), bone mineral density (BMD)and bone metabolism in growing rats. Methods 48 male SD rats were divided into the high-intensity exercise group (T1, n=12), high tolow-intensity exercise group (T2, n=12), low-intensity exercise group (T3, n=12) and control group (Con, n=12). During the first 6 weeks,the rats in T1 and T2 group ran on treadmill with high intensity, while rats in T3 group took low-intensity treadmill exercise. 6 rats were sacrificedfrom each group at the end of 6th week. BMC, BMD of femur were measured with DEXA. Alkaline phosphatase (ALP), osteocalcin(BGP), tartrate-resistant acid phosphatase (TRACP) were detected with ELISA. The exercise intensity of T2 group was reduced rapidly to alow level as in T3 group, but remained in the other 2 groups. At the end of the second 6 weeks, the other rats were investigated again. ResultsCompared with the first measurements, ALP and BGP of the T2 group decreased significantly (P<0.05), and TRACP increased (P<0.05). There was no significant difference in BMC and BMD of femur (P>0.05). Conclusion Rapid reduction of physical activity can suppressbone formation and stimulate bone resorption of long bone among growing rats.

Objective To compare the surgical outcomes between microsurgery lumbar discectomy and microendoscopic discectomy for lumbar disc herniation. Methods A prospective study was conducted on the surgical procedures for lumbar disc herniation.The target of our study was a group of 33 patients who underwent surgery by microsurgery lumbar discectomy(MSLD group)and 36 patients who underwent surgery by microendoscopic discectomy(MED group).The items investigated were the operation time,amount of bleeding,duration of hospitalization,pre-and postoperative scores based on judgment criteria for treatment of lumbar spine disorders established by the Japanese Orthopaedic Association score,visual analog scales (VAS,0 to 10) for lumbago and sciatica before surgery and at discharge,perioperative complications.Results The mean duration of follow-up was 2 years and 2 months (11 months to 4 years).There were no significant differences between the 2 surgical procedures in the frequency of the pre-and postoperative Japanese Orthopaedic Association scores or postoperative VAS for lumbar pain and sciatica,operation time and duration of hospitalization. Statistically significant differences were observed in amount of bleeding and operation time,but the differences were not large, and may not have been clinically significant.Conclusion Both microsurgery lumbar discectomy and microendoscopic discectomy are appropriate for lumbar disc herniation.

Objective:To study the influence of protein transduction domain (PTD)-oligomerization domain (OD)-HA fusion proteins on apoptosis of bcr/abl-positive cell lines. Methods:bcr/abl-positive cells were treated with PTD-OD-HA protein. The apoptoses of the cells were detected by flow cytometry (FCM), DNA ladder and transmission electron microscopy (TEM), and the levels of apoptosis-related genes bax and bcl-2 were detected by RT-PCR and Western blotting. Results:FCM examination demonstrated that PTD-OD-HA protein induced the apoptosis of bcr/abl-positive cells; DNA ladder showed that the classic DNA ladders appeared in BaF3-P210 and K562 cells after 48 h treatment with PTD-OD-HA proteins; the apoptoses of BaF3-P210 cells were observed by TEM; the levels of bax in mRNA and protein increased in BaF3-P210 and K562 cells, and bcl-2 decreased. Conclusion:PTD-OD-HA proteins specifically induced the apoptosis of bcr/abl positive cells.

Objective To investigate the effects of circadian clock gene Period2(Per2)on the proliferation,differentiation and apoptosis of K562 cells and its probable molecular mechanism.Methods The Per2 expression plasmid pcDNA3.1-Per2 and empty control plasmid were respectively transfected into K562 cells with cationic liposome,and the resistant cells stably expressing Per2 gene were obtained by G418 selection.Their morphological changes were observed under light microscope following Wright-Giemsa staining.Trypan blue excluding staining and MTT assay were employed to evaluate cell proliferation.Flow cytometry was performed to analyze cell cycle distribution and cell apoptosis,and electron microscopy was used to detect cell apoptosis.Meanwhile,the expressions of proliferation and apoptosis associated proteins,such as P53,Cyclin B1 and C-Myc,were respectively detected by RT-PCR and Western blot analysis at mRNA and protein level.Results The K562/Per2 cell line stably expressing Per2 gene was screened out.As compared with either the empty plasmid transfected group(K562/empty)or the untreated group(K562/untreated),K562/Per2 cells was smaller in volume and showed no obvious cellular differentiation.Circadian clock gene Per2 could significantly inhibit both growth and proliferation of K562 cells.The percentage of K562 cells in G2/M phase increased [K562/Per2 group(36.1?5.5)%,K562/empty group(12.5?2.9)%,untreated group(9.7?2.3)%,P

Objective To evaluate 18F-FDG hPET/CT in the diagnosis of postoperative recurrence and metastasis of colorectal cancer. Methods GE HAWKEYE coincidence SPECT was carried out in 81 colorectal cancer patients with suspected recurrence or metastasis after intravenous injection of 259 ~ 298 MBq (7-8 mCi) 18F-FDG. The acquired data were reconstructed using iterative algorithm and attenuation-corrected X-ray. The results were compared with the final diagnosis established by histological examination of resected specimens、and clinical follow-up. Results The sensitivity, specificity, positive predictive value (PPV)and negative predictive value(NPV)was 93% (57/61)、80% (16/20)、93% (57/61)、80% (16/20) for 18F-FDG hPET/CT respectively. For conventional CT the sensitivity, specificity, PPV and NPV was 67% (37/55)、73% (19/26)、84% (37/44)、51% (19/37) respectively; 18F-FDG hPET/CT detected 91 recurrent or metastatic lesions whereas only 46 lesions were detected by conventional CT in 65 patients. Conclusions 18 F-FDG hPET/CT has unique value in the diagnosis of recurrence and metastasis in postoperative colorectal cancer patients which was superior to conventional CT. Combined 18 F-FDG coincidence imaging with localizing CT improves the detection and localization of postoperative recurrence and/or metastasis in colorectal cancer patients.

Objective To construct the transformed mouse BaF3-P210 cell line stably expressing BCR/ABL and to initially investigate the influence of BCR/ABL on the cell biological characteristics of BaF3 cell line. Methods The retroviral vector with bcr/abl gene was transfected into the packaging cell line. The BaF3 cells were infected with the collected viral supernatant. The transgenic BaF3-P210 cell line stably expressing BCR/ABL were screened and subcloned. The integration of the bcr/abl gene in the genome of the target cell was determined by PCR and DNA sequencing,trypan blue staining assay,flow cytometry and MTT assay. Results The bcr/abl gene was integrated into the BaF3 cell genome; RT-PCR and Western blot verified the stable expression of the bcr/abl gene and protein in the screened subclone cell line BaF3-P210. Compared with the control group,the cell proliferation rate was promoted (P