BACKGROUND:Different operation approaches can be selected during the repair of thoracolumbar fractures. Traditional posterior median approach wil cause great wound on patients, and easily induces some adverse consequences. OBJECTIVE: To compare the effects and biocompatibility of conventional posterior median approach and paraspinal approach fixation for treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on clinical data of 53 cases of thoracolumbar fracture in the Shaanxi Province Nuclear Industry 215 Hospital from December 2012 to December 2013. They were divided into two groups according to approach method. The control group (n=27) received pedicle screw placement fixation through conventional posterior median approach. The observation group (n=26) underwent pedicle screw placement fixation through paraspinal muscle approach. After repair, they were folowed up for 12 months. Imaging results, pain score and perioperative relevant indexes were observed and compared in both groups. RESULTS AND CONCLUSION: Imaging examination was conducted before repair, immediately after repair and during final folow-up in both groups. The height of vertebral anterior border and kyphosis correction effect were good after different therapies in both group, but no significant difference was detectable between the two groups (al P > 0.05). These findings suggest that height of vertebral anterior border and kyphosis correction effect were identical between the two groups. Pain visual analog scale score was significantly lower in the observation group than in the control group at 24 hours and 3 days after repair and during final folow-up (al P < 0.05). Perioperative relevant indexes were analyzed in both groups. Intraoperative bleeding amount, drainage and bed time after repair were observed in the observation group, which showed significant advantages as compared with the control group (al P < 0.05). These results confirmed that compared with the traditional posterior median approach surgery, minimaly invasive pedicle screw placement through paraspinal muscle approach for thoracolumbar fractures can obtain better repair effects and biocompatibility.

Objective To investigate the blood glucose changes in critically ill patients taken continuous renal replacement therapy(CRRT)before treatment and at different time points after treatment. Methods Sixtyseven critically ill patients were enrolled in the study,of whom 13 cases were treated conventionally and assigned as pre-treatment control group,while the other 54 cases undertook CRRT were assigned as CRRT group. The CRRT group were further sub-divided into four groups according to CRRT time((CRRT time ＜6 h group(n = 18),CRRT time of 6 - 12 h group(n = 18),CRRT time ＞ 12 h group(n = 18);or sub-divided into two groups according to circulating blood temperature(≤ 36. 5 ℃ group(n =27)and ＞ 36. 5 ℃ group(n =27));or sub-divided into two groups by sugar substitute fluid replacement solution as the formula group(the standard level of sugar content was 6. 9 mmol/L(n = 27)and sugar-free replacement fluid group(n = 27);or sub-divided into two groups according to the Glasgow Coma score(GCS)(GCS ≤ 8 points group(n = 24)and GCS ＞ 8 group(n = 30). Blood glucose level at different time points were measured. Results The longer CRRT cycle time,lower temperature,sugar substitute fluid replacement fluid worse GCS score corresponded to more dramatic blood glucose fluctuation at different time points in CRRT group,and it took longer time for them to recover to normal blood sugar level Conclusions During the CRRT process insulin secretion was suppressed and led to increase of blood sugar. In most cases the blood glucose returns to normal after CRRT treatment over time,but a small number of cases require clinical intervention.

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.
Apoptosis ; Autophagy ; Humans ; Microtubule-Associated Proteins ; physiology ; Signal Transduction ; Ubiquitination

Objective To investigate the effect of the mild conjunctivitis complication on the tear break-up time(BUT) in pa-tients with dry eye .Methods 93 patients with dry eye from Sep .2007 to Sep .2011 were selected .For all of them the BUT was 5 seconds or less than 5 seconds after corneal fluorescein staining .They were divided into experimental group (with mild conjunctivi-tis) and control group (without mild conjunctivitis) .We checked the BUT and compared the difference of BUT between experimen-tal group and control group .Results The average BUT of the 54 patients with complicated mild conjunctivitis ,of which conjuncti-val papillae was found in 40 cases ,was (3 .54 ± 1 .02)s ,the average BUT of the 39 patients without conjunctivitis was(3 .41 ± 1 .04) s .There was no significant difference between two groups .Conclusion Dry eyes complicated mild conjunctivitis had no effect on BU T .

ObjectiveTo estimate the effect of azithromycin on lung function and transforming growth factor β1(TGF- β1) in patients with idiopathic pulmonary fibrosis (IPF). MethodsOne hundred and ten patients with IPF were divided into two groups by random digits table. Patients in azithromycin group(60cases) were treated by azithromycin tablets and thoee in placebo group ( 50 cases) were treated by placebo tablets, and they were observed for 12 weeks. Lung function was detected at beginning and after 6,12 weeks' treatment. TGF- β1 was tested by ELISA, meanwhile patient's condition was observed. ResultsAfter 6 and 12 weeks' treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), carbonmonoxide diffusion capacity (DLCO) in the two groups had no significant differences compared with those at beginning of treatment (P ＞ 0.05). After 12 weeks' treatment, the level of TGF- β1 in azithromycin group was significantly decreased compared with that at beginning and after 6 weeks' treatment (P ＜ 0.05) ,but there was no significant difference in placebo group (P ＞ 0.05). The ratio of acute exacerbation admission and infection was 8.3％(5/60) and 60.0％(3/5) in azithromycin group, 22.0％( 11/50) and 81.8％(9/11 ) in placebo group,and there were significant differences between the two groups(P ＜0.05 or ＜0.01). Conclusion Azithromycin may reduce the ratio of acute exacerbation admission and infection, decrease TGF- β 1 expression in patients with IPF by taking orally for a long time, but it may have no obvious effect on lung function.

Objective To explore more effective treatments for irritable bowel syndrome(IBS)in old people.Methods 80 patients with irritable bowel syndrome were selected.adverse drug reaction during treatment,and therapy effect of a symptom score after treatment observation group and control group were compared.Results Total improvement rate of symptoms from observation group was 91.7％,and total improvement rate of symptoms in control group was 65.6％.Difference of proportions of significant improvement and improvement was significant,according to the situation that was controlled between observation group and control group.The difference of symptom score after treatment was significant,according to the situation that was controlled between observation group and control group.Conclusion Trimebutine maleate,oryzanol and anisodamine combined application could remarkably improve irritable bowel syndrome treatment effect,and was more safe.

ObjectiveTo explore curative effect of eradication of Helicobacter pylori by sequential therapy and traditional triple therapy.MethodsTo retrospective analyze clinical data of Helicobacter pylori masccline patients,which were divided into the sequential therapy group and the traditional triple therapy group.ResultsThe results of ITT analyze and PP analyze of the sequential therapy group were higher than those of the traditional triple therapy group (x2 =19.30,11.18,all P ＜ 0.05) ;The total effective rate of clinical curing of the sequential therapy group was higher than that of the traditional triple therapy group( x2 =14.25,P ＜0.05 ) ;The untoward reaction rate of the sequential therapy group was lower than that of the traditional triple therapy group( x2 =10.53,6.93,6.93,all P ＜0.05 ).ConclusionThe curative effect of eradication of Helicobacter pylori by the sequential therapy were obviously and little untoward reaction rate,which was to be worthy used.

Objective To discuss the clinical features and treatment of hepatogenous diabetes. Method Retrospective analysis was conducted in January 2002-April 2009 170 cases of clinical data in patients with liver cir-rhosis. Result 170 cases of liver cirrhosis 40 cases of diabetes, the incidence was 23.5% ,various types of cirrhosis may occur;typical "over three" obvious symptoms; 10 cases admitted tohospital when fasting blood glucose≥7.0 mmol/L, postprandial 2 hours blood glucose were ≥1.1 mmol/L;high level of total bilirubin,serum albumin,cholin-esterase,total cholesterol low. Given to diabetic diet and small doses of ct-glucosidase, short-acting insulin treatment; 26 cases of normal blood glucose, improvement in 8 cases (blood glucose 6. 1～11.1 mmol/L) ;6 deaths. Conclusion Prone to occur in patients with liver cirrhosis glucose metabolism disorders, its clinical features, treatment of liver damage and the need to take into account two aspects of diabetes, the use of insulin as the main.

Objective To investigate the expression of vascular endothelial growth factor C(VEGF-C ) in tissue, serum and lymph fluid in esophageal cancer patients, and the relationship between its expression and tumor lymphatic metastasis. Methods Expressions of VEGF-C in 76 cases of ESC was detected by immunohisto-chemical SP method and VEGF-C levels in lymph fluid and serum were assessed by enzyme-linked immunosorbent assay. Results Positive immunostaining of VEGF-C in esophageal cancer tissue was 63.1%,The expression of VEGF-C in tissue was significantly associated with lymph node metastasis and TNM stage ( P<0.01, P<0.05 respectively), but not to patient age, tumor length or differentiation; VEGF-C in lymph fluid is significantly higher than in serum( P<0.05) ; The expression of VEGF-C in lymph fluid end serum were significantly associated with lymph node metastasis( P<0.05). Conclusion There are cliuical significance between VEGF-C expression and lymph node metastasis、TNM stage in tissue of esophageal cancer. The level of VFGF-C in lymph fluid is higher than that in serum, both associate with lymph-node metastasis closely.

Objective To investigate the effect of tacrolimus on the expression of nuclear factor-κB (NF-κB) in HaCaT cells stimulated by tumor necrosis factor-α(TNF-α),and on the expression of glucocorticoid receptor (GR)α and β in untreated HaCaT cells in vitro.Methods Cultured Ha CaT cells were treated with TNF-α(10μg/L) only,combination of TNF-α(10μg/L) and various concentrations (10-8mol/L, 10-7mol/L,10-6moL/L) of tacrolimus or tacrolimus of different concentrations only.After additional 12-,24-, 36- or 48-hour cnlture, Westem blot and immunofluorescenee-confocal laser scanning microscopy were used to detect the expressions of NF-κB,GRα and GRβ in HaCaT cells.Those untreated HaCaT cells served as the control.Results The relative protein expression level of NF-κB was increased in HaCaT cells after treatment with TNF-α for 24 and 48 hours zompared with untreated ceils (0.73±0.0316 and 0.8925±0.0171 vs 0.4988±0.03506,both P<0.05);however,the increase in NF-κB expression was inhibited by the combination treatment with tacrolimus,and the relative expression level of NF-κB protein was 0.6825±0.0263.0.6200±0.0163 and 0.5575±0.0299 in HaCaT cells treated with TNF-α plus tacrolimus of 10-8mol/L 10-7mol/L and 10-6mol/L,respectively;the difference was significant etween TNF-α-treated cells and those dealt with the combination of NF-α and tacrolimus of 10-7 or 10-6 mol/L (both P<0.05).No significant difference was observed in the expression of NF-κB by HaCaT cells between different time oints treated with tacrolimus of 10-8,10-7 or 10-6 mol/L.Also,there was no zignificant difference in the expression of GRα or GRβ between untreated HaCaT cells and those treated with tacrolimus of 10-8, 10-7 or 10-6 mol/L at any time point.Conclusions Tacrolimus ould inhibit the expression of NF-κB by TNF-α-stimulated HaCaT cells,but does not affect the expression of GRα or GRβ,in untreated HaCaT cells.