Percutaneous vertebroplasty (PVP) is a relative new interventional technique, which is widely used in treatment of vertebral collapse caused by vertebral neoplasms and osteoporotic compression fractures. The general technical considerations of PVP techniques are discussed based on authors' experience obtained over 400 patients in the past years in this article, including preparation of PMMA, instrument of PVP, guidance and puncture approaches, and technique of the procedure, etc. The conclusion is that PVP is a safe procedure if the physicians handle it properly.

Objective To observe the characteristics of hemorheologic changes of hyperlipidemia rats at an early stage and to explore the mechanism of myocardial ischemic injury.Methods Seventy-two SD rats which were fed with high cholesterol diet(cholesterol+lard+pig bile salt) to result in hyperlipidemia model fell into HC group.Thirty-six SD rats which were fed with common diet fell into control group.The rats were fed for 10 to 90 d.At an interval of 10 d,9 time points were set.Therefore the 2 groups were randomly divided into 9 subgroups.At each time point,the changes of plasma lipids,cTnI,hemorheologic parameters,and pathological change of the rats’ myocardium and coronary vessel were assayed.Results The main characteristic of our models was hypercholesterolemia and high low-density-lipoproteins(LDL).With the extension of feeding time,plasma viscosity of HC group increased significantly,and erythrocyte deformability decreased.After fed with cholesterol for 50 d,myocardial ischemic injury occurred in the HC group.Correlation analysis revealed that the incidence of myocardial ischemic injury in hyperlipidemia rats was closely related with hypercholesterolemia and high low-density-lipoproteins.Conclusion The abnormal change of hemorheologic characteristics of hypercholesterolemia is a cause of myocardial ischemic injury.

Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP) and endovascular chemotherapy and embolization for the treatment of vertebrae malignant tumors. Methods Twenty nine patients (male 16, female 13) had 40 vertebrae malignant tumors, including 28 patients with 37 vertebrae metastases and 1 patient with multiple myeloma involving 3 vertebrae. The primary foci were esophageal cancer, lung cancer, colon carcinoma, hepatic cancer, stomach cancer, breast cancer, kidney cancer and 2 of unknown. All the patients showed moderate or severe thoracic and lumbar pain with 2 patients of spinal cord dysfunction. Eighteen cases with 26 vertebrae were performed PVP only, 11 cases with 16 vertebrae were undergone endovascular chemotherapy and/or embolization. Results After treatment among 29 patients, 16 had CR(55.1%), 12 had PR(41.4%), 1 was unsuccessful with PVP but pain was relieved by endovascular therapy. No complication occurred.Conclusions PVP and PVP combined with endovascular therapy may have an excellent efficacy for vertebral malignant tumors, with relief of pain obviously and prolong the patient's life.

Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18?5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

Objective The effects of AM fungi on the growth of Bupleurum chinense were investigated by inoculation Glomus mosseae, G. caledonium, and the two fungal mixture under different phosphorus levels. Methods Pot culture and experimental analyses were carried out. Results Mycorrhizal infection rate could be promoted by inoculation and increased phosphorus content of plant and root dry weight; the content of chlorophyll, carotenoids, and soluble sugar of leaf was higher than that of controlled plant, and the soluble sugar content of plant root by inoculation the two fungal mixtures were lower than that of controlled plant. The inoculation effect of AM fungi was closed related to AM fungal species and phosphorus applied levels, which was the best under 0.1—0.3 g/kg P_2O_5 soil. Conclusion The growth of host plant and using rate of phosphorus fertilizer can be promoted by inoculation of AM fungi.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation (LDH) after the treatment of percutaneous lumbar discectomy (PLD), and to discuss the influential factors related to the long-term effectiveness. Methods During the period of January 2000 to March 2002, PLD was performed in 129 patients with LDH. By using self-evaluation questionnaires of Oswestry disability index (ODI), Short Form-36 (SF-36) and Japanese Orthopaedic Association (JOA) through letter or telephone interviews as well as the patients' initial medical records, the related clinical data were collected. Statistical analysis was conducted by using Wilcoxon's rank sum test, Chi-square test. Results One hundred and eight patients (83.7%) were able to be followed up and 104 effective ques-tionnaires were collected. The mean follow-up time was (6.64 ± 0.67) years, the excellent rate (ODI score, 0 ～ 20%) was 71.15%. The average scores of the JOA and SF-36 was 23.66 ± 5.72 and 75.88 ± 25.57, respectively. The scores of quality of life were obviously improved in all follow-up subscales. Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD. No complications related to PLD occurred in this study. The age, course of the disease and the patient's condition at the time of discharge might bear a relationship to long-term effectiveness. Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect, PLD can dramatically improve the quality of life. Many factors, such as the age, course of the disease and the patient's condition at the time of discharge, can affect the long-term outcomes.

Objective To evaluate the predictive value of Wells score combined with D-dimer in the diagnosis of acute pulmonary embolism.Methods A total of 540 patients with suspected pulmonary embolism admitted from 2008 to 2011 were enrolled for study.The diagnosis of pulmonary embolism (PE) was confirmed by using computed tomography pulmonary angiography (CTPA).These patients were divided into two groups:PE group and non-PE group.Comparative analysis was carried out in demographics,underlying diseases,chief complaints,physical signs,venous thrombosis risk factors,laboratory findings and Wells scores between the two groups.Results Of 502 patients selected into this study,there were 246 in PE group and 256 in Non-PE group.The incidence rates of history of recent surgery or bed-ridden,recent fracture of pelvis or lower limb,symptoms of hemoptysis,transient disturbance of consciousness,signs of unilateral lower limb swelling,hypoxia and hypocapnia of arterial blood gas analysis,elevated levels of D dimer,high Wells score in PE group were significantly higher than those in non-PE group (P ＜ 0.05).And there were no statistical difference in other variables found between the two groups.The areas under the ROC curve of Wells score,D-dimer and the combination of the two were 0.775 (95％ CI:0.719-0.831),0.802 (95 ％ CI:0.751-0.853) and 0.899 (95 ％ CI:0.834-0.964),respectively.And the area under the ROC curve of the combination of the two was greater than that of separated application (P ＜ 0.05).When the cut-off value of Wells score was 5 and D-dimer was 1 724 μg/L,the weighted maximum sensitivity and specificity were reached,and these cut-off values were higher than above determined values,the reliability of the diagnosis of PE was obviously increased,and those were lower than these cut-off values,the reliability of excluding PE was also increased.Conclusions Wells score combined with D-dimer showed a higher value in predicting acute pulmonary embolismthan than their separated application.

A study of 10 cadavers and 100 CT scans of lumbar spine was performed to investigate the topographical anatomy of the posterolateral disc puncture in percutaneous lumbar discectomy.A way of the puncture at L_5-S_1 disc,with comparative plain films of lumbar spine in different positions were taken in 50 cases.The results showed that the pos- terolateral approach for percutaneous discectony was a safe way.However,it is important to have full knowledge of the regional topographical anatomy associated with the puncture tech- nique to avoid the potential neurovascular complications.The special position designed by authors for the puncture at L_5-S_1 disc is useful by lowering the position of iliac crest which hinders the entrance of needle,thus can raise the successful rate of the percutaneous discec- tomy 100% successful rate of the disc puncture at L_5-S_1 disc was obtained in 130 cases.The two puncture parameters of Chinese associated with percutaneous lumbar discectomy were first measured;and also the route including nearby structures,the complications were dis- cussed.

Selective salpingography and transvaginal catheter dilatation using a self- made coaxial catheter set were performed in 45 women with infertility and fallopian tube ob- struction.The successful catheterization rate was 95.5% for fallopian tubes and the recanal- ization rate proximal allogian tubes was 80%,Normal intrauterine pregnancy was achieved in total 15 women(33.3%)with in two years follow-up 50% and 17.4% pregnant rates were obtained in secondary infertility and primary infertility,respectively.The authors be- lieve that transvaginal catheter dilization is a useful method for female infertility with fallopi- an tube obstruction,especially for the secondary infertility and proximal fallopian tube ob- struction.The self-made coaxial catheter set holds the advantages of effectiveness,safety, and inexpensiveness.

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.