BACKGROUND:Because it can reduce the risk of postoperative bone cement leakage, percutaneous kyphoplasty is increasingly used for treatment of severe osteoporotic thoracolumbar vertebral compression fractures. Studies have found that injection of mixed bone cement with high viscosity can significantly reduce the leakage of bone cement. OBJECTIVE:To compare the therapeutic efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with standard viscosity bone cement in the treatment of severe osteoporotic thoracolumbar vertebral compression fractures. METHODS:Eighty patients with severe osteoporotic thoracolumbar vertebral compression fractures were enroled and randomized into vertebroplasty group and kyphoplasty group, 40 patients in each group. Visual analog scale score and Oswestry disability index score were compared between groups before and after treatment. Incidence rate of bone cement leakage and other complications were also compared between two groups after treatment. RESULTS AND CONCLUSION:No significant difference was found between the visual analog scale scores of two groups after treatment (P> 0.05). Patients in the two groups al presented with good recovery of spinal function after treatment, and there was no difference in the Oswestry disability index scores between groups at 3 months after treatment (P> 0.05). The incidence rate of bone cement leakage was 45% in the vertebroplasty group and 30% in the kyphoplasty group, with a significant difference (P < 0.05). But the patients in both groups showed no obvious clinical symptoms and underwent no treatment. After treatment, al patients had no pulmonary embolism, bone cement toxicity, spinal cord and nerve root injury. These findings show that there is no significant difference between percutaneous vertebroplasty and kyphoplasty with high-viscosity bone cement in the folowing aspects: pain improvement, recovery of the spinal function, incidence rate of bone cement leakage and clinical efficacy.

Objective: To investigate the significance of laminin(LN) and laminin receptor(LN-R) in the proceeding and prognosis of hydatidiform mole.Methods: Immunohistochemical SP staining was used to detect the expression of LN and LN-R in 41 hydatidiform mole cases(13 cases were learned to have turned malignant by following up).20 cases of normal early gestational chorion were detected as control.Results: The strong positive rates of LN and LN-R in normal chorion,hydatidiform mole un-malignant group and malignant group were respectively 90.0%(18/20),71.4%(20/28),38.5%(5/13),and 70.0%(14/20),71.4%(20/28),84.6%(11/13).The strong expression of LN had a significant difference between malignant group and the other 2 groups(P

Objective To evaluate the clinical significance of colonoscopy in the diagnosis of pathological changes of terminal ileum.Methods The clinical characteristics of terminal ileum,endoscopic manifestations and pathological results of 72 cases were retrospectively summarized.Results 72 cases of terminal ileum lesions diag-nosed with terminal ileum 32 cases,28 cases of lymphoid follicles hyperplasia,polyps in 5 cases,crohn's disease (3 cases),intestinal tuberculosis in 1 case,lymphoma in 1 case,small intestinal carcinoma in 1 case,terminal ileum bleeding in 1 case.Conclusion Colonoscopy is the first choice for diagnosis of terminal ileum diseases and effective method,for early diagnosis and treatment of terminal ileum diseases have important clinical significance.

Objective To explore the etiology of abdominia incision hernia and treatments of giant incisional hernia of abdominal wall. Methods 14 cases with AGIH treated in our hospital from Oct 2003 to May 2008 were analyzed retrospectively. Results The etiology of abdominia incision hernia were very important,and abdominal longitudinal incision was performed, 10 cases ＞ 67y among 14 cases with incision hernia were 71.42%. Infection of incision and essential conditions( diabetes, chronic cough ,hypoalbum inemia)were also easily induced of incisional hernia. All of them chose the marlex patch. The cases were all cured and no serious postoperative complications. None of cases recurred during a follow up of 3 to 56 months. Conclusion The etiology of AGIH related with longitudinal incision,old ( ＞ 60y)and essential conditions. AGIH were repained with polypropylene mesh. Essential conditions should be treated before operation and abdominal wall should be trained comfortablely. Repairing abdominal incision hernial with artifical patch was a safe and simple operation with minimal postoperation pain.

The constitutional medical thoughts in Inner Canon of Huangdi is the foundation for TCM constitution theory, it discusses the influence of constitution on disease in detail. Constitution factors determine the disease onset or not; Constitution factors determine the tendency and character of disease. Constitution factors effect the changes of pathogenesis, the character of syndrome, the therapeutic principle and methods; Constitution factors effect the turnover and prognosis. Constitution therapies are profit to correct the partial body, preventing the development of disease and heal the disease.

Objective To investigate the application value of intraoperative ultrasound (IOUS) in living donor liver transplantation(LDLT). Methods In LDLT, IOUS techniques (gray scale ultrasound and color Doppler flow imaging) were adopted in 26 donors and recipients for parenchymal and vascular examinations. The abnormal sonograms were observed, and the anatomic findings of hepatic veins were recorded. All the reanastomosed blood vessels were examined by gray scale ultrasound and color Doppler flow imaging before the operations were completed. Results A hepatic parenchymatous tumor was revealed by IOUS in one donor. Besides, middle hepatic veins in 13 donors and secondary hepatic veins with diameter﹥0.5 cm in 5 donors were confirmed by IOUS. Furthermore, one operation procedure was changed and one hepatic artery stenosis was established according to IOUS findings. Conclusion IOUS is a very useful means in evaluation of parenchymal and vascular conditions of donors and recipients in LDLT, which helps to select the best cross section and provides evidence for the change of surgical procedures.

Objective: To observe the effects of different concentrations of glucose on the expression of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), osteoprotegerin (OPG), and the ligand of osteoprotegerin (OPGL) in osteosarcoma MG63 cells, so as to assess the role of glucose in pathogenesis of diabetic osteoporosis. Methods: MG63 cells were incubated with glucose at the concentrations of 5.5,16.7,33.3 mmol/L for 24 h. The expression of TRAIL, OPG and OPGL mRNA were examined by RT-PCR. Expression and distribution of TRAIL in MG63 cells were investigated by immunohistochemical method. Results: The mRNA expression of TRAIL and OPGL in MG63 cells increased in the order of control group, 5.5,16.7,33.3 mmol/L glucose groups(P<0.05), and the expression of OPG mRNA decreased in the same order(P<0.05). TRAIL mRNA level in 33.3 mmol/L glucose group was significantly higher than that in the control group [(1.004±0.070) vs (0.740±0.023), P<0.05] and the expression of TRAIL was stronger than that in the control group. Conclusion: High concentration of glucose can lead to increased expression of TRAIL and OPGL in osteoblasts and decreased expression of OPG, which may be one of the key pathogenetic factors of diabetic osteoporosis.

Scleral buckling surgery is a main surgical method for rhegmatogenous retinal detachment, and it is the basic skill of retinal surgeons. As a kind of classic treatment, retinal surgeons must recognize and understand the essence and connotation of scleral buckling surgery, master and apply skillfully, improve the success rate of rhegmatogenous retinal detachment, and use the minimum amount of surgical combination to achieve anatomical retinal reattachment and restore visual function as much as possible.

The clinical data of a patient with maturity-onset diabetes of the young 11 (MODY11) caused by B lymphocyte kinase( BLK) gene mutations in Children′s Hospital Affiliated to Nanjing Medical University in August 2018 were retrospectively analyzed.The diabetes mellitus epidemiologic investigation was carried out on the patient′s family.The 13-year-old boy was diagnosed with type 1 diabetes at the local hospital 6 months ago.Physical examination showed that he was 65.5 kg in weight, 169.2 cm in height and 22.9 kg/m 2 in the body mass index.He was overweight without acanthosis nigricans.Laboratory measurements revealed fasting blood glucose 11.79 mmol/L, fasting insulin 18.05 mmol/L, and fasting C-peptide 1.12 mmol/L.The glycosylated hemoglobin was 12.0%, while the islet antibodies were all negative.Among 4 consecutive generations of this family, 11 members presented with diabetes, 8 cases of who were treated with insulin and 3 cases with oral hypoglycemic drugs.The whole exome sequencing identified a heterozygous mutation in exon 9 of BLK (c.809C>T) in this patient and his mother.This mutation caused the amino acid change p. T270M (threonine>methionine). Many cases of MODY are misdiagnosed as either type 1 diabetes or type 2 diabetes.MODY11 is rare, mostly characterized by overweight or obesity, insufficient serum insulin secretion and commonly insulin dependence.

Xuangan Oral Liquid can increase blood platelets to a normal level in mice with thrombocytopenia induced by chemotherapy and radiotherapy. It was shown that Xuangan Oral Liquid can reduce blood coagulation time in mice through capillary and tail-cutting methods, and the difference between control group and treatment group is significant.