[Objective]To investigate the metaphase result of extensive fusion in treatment of spondylolisthesis combined with intervertebral disc degeneration of adjacent joints.[Methods]Seventy-nine cases of lumbar spondylolisthesis combined with intervertebral disc degeneration of adjacent joints were treated with extensive fusion and internal fixation from September 2002 to September 2007.JOA and VAS scores were assessed and compared pre-and post-operatively.X-ray and CT were performed to observe the stabilization of fusion joints,and satisfaction rate from patients was investigated.[Results]All patients were followed up for 2 to 6.5 years(mean,4.6 years).Post-operative JOA scores increased(P

Objective:To research the relationship of urinary cytology positive rate with the grade and stage of primary ureter uroepithelium cancer.Methods:A total of 104 cases of primary ureter uroepithelium cancer were recruited in this study.The urine of all paitents was collected for preoperative urinary cytology de-tection.The urinary cytology detection rates were compared among different grades and stages of primary ureter uroepithelium cancer.Results:The overall unnary cytology positive rate of primary ureter uroepithelium cancer was 34.26%.The overall urinary cytology positive rate was 43.59%in the advanced stage group and 11.54%in the low stage group,with a significant difference(X2=8.740, P=0.003).The difference in positive rate between the advanced stage group and the low stage group in the high grade with inferior segment group of primary ureter uroepithelium cancer was statistically significant(X2=10.628,P=0.001).The difference in positive rate between the advanced stage group and the low stage group in the high grade group of primary ureter uroepithelium cancer was statistically significant(X2=5.678,P=0.01 7).The difference in positive rate be-tween the high grade group and the low grade group in low stage group of primary ureter uroepithelium can-cer was statistically significant(X2=12.860,P=0.001).Conclusion:The unnary cytology positive rate of primary ureter uroepithelium cancer of high grade and low stage is higher.

Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision and open nephroureterectomy in pelvis carcinoma. Methods We retrospectively analysed the records of all 62 patients who underwent retroperitoneal laparoscopic or open nephroureterectomy in Tianjin Dagang Hospital or the Second Affiliated Hospital of Tianjin Medical University from July 2001 to July 2009. Variables analyse were compared including operative time, blood loss, turning to open operation, complications, length of stay, tumor recurrence and metastasis. Groups were compared using Student's t-test, and a probability (P) value of less than 0.05 was taken to indicate statistical significance. Results The respective mean operative duration [(47.34±39.16) vs (118.17±44.65) ml], length of hospital stay [(9.15±2.19) vs (11.64±3.71) d], time to ambulation [(3.58±0.79) vs (5.67±1.24) d]and blood loss [(70.64±27.33) vs (118.17±44.65) ml]in retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision group was significantly reduce to open nephroureterectomy group (t = 3.3167, 2.0587, 8.0494, 5.1777, P ＜0.05). There was no significantly difference between two groups in complication of during operation and post operation [4.8 % (2/42) vs 5.0 %(1/20), 0 vs 0, respectively](P ＞0.05). 4 cases were failed and conversed to open surgery in retroperitoneal laparoscopic nephroureterectomy group. During the follow up period range from 8-48 months, there was no significantly difference between two groups in tumor recurrence and metastasis [4.8 % (2/42) vs 5.0 % (1/20),2.4 % (1/42) vs 5.0 % (1/20), respectively](P ＞0.05). Conclusion Retroperitoneal laparoscopy in upper urinary tract transitional carcinoma uses a small incision, incurs less blood loss, and allows for a more rapid recovery, suggesting it is a safe and effective method for treating patients with renal and pelvis cancer.

Type 2 diabetes mellitus is a metabolic disorder characterized by hyperglycemia caused by multifactors.The incidence of type 2 diabetes is gradually increased.Its prevention and treatment are paid more and more attention.Intestinal flora is one of the hot spots in recent years.A large number of studies have shown that intestinal flora is closely related to the occurrence and treatment of type 2 diabetes mellitus.Intestinal flora is expected to be a new direction for the improvement and treatment of type 2 diabetes mellitus.In this paper,the relationship between type 2 diabetes and intestinal microflora in recent years,pathogenesis and treatment were summarized.

Objective To observe the effects of Jiuxieling granules on rats with ulcerative colitis and explore its mechanism.Methods Ulcerative colitis models were established by immune method combined with local stimulation of 5% acetic acid.Wistar rats were randomly divided into control,model,positive control and low,middle,high dose Jiuxieling granules group.Rats in positive control group were treated with sulfasalazine,and those in three treatment groups were treated with low,middle and high dosage of Jiuxieling granules respectively for 14 days continuously.24 hours after last administration,the rats were killed to obtain colon mucous membrane to test GSH-Px,SOD,MDA,NO,tNOS and iNOS concentration of the homogenate of colon mucous membrane.Results Jiuxieling granules could markedly improve the levels of GSH-Px and SOD activity,whereas decrease the levels of MDA,NO,TNOS and iNOS.Conclusion Jiuxieling granules exert its marked curative effects on rats of ulcerative colonitis by resisting oxygen free radical lesion,inhibiting the generation of NO and NOS,and enhancing the activity of antioxidase.

Background Dry eye is the most common ocular surface disease.Anterior segment pattern of optical coherent tomography (OCT) is able to be used to assess the tear meniscus directly and accurately.Objective This study was to evaluate the correlation between measuring outcomes of tear meniscus by anterior segment module of OCT with signs and symptoms of dry eye.Methods A retrospective serial cases-observational study was designed.Thirty-six patients who completed Ocular Surface Disease Index (OSDI) and got a score more than 20 were enrolled in the First Hospital of Peking University from September to October,2010 under the informed consent.The upper and lower tear meniscus height (U/LTMH,μm),depth (U/LTMD,μm) and cross sectional area (U/LMA,mm2) were measured with the anterior segment module of OCT (RTVue.pitch).A series of clinical tests were performed,including tear film interferometry,break-up time (BUT),fluorescein corneal staining,lissamine green conjunctival staining and Schirmer Ⅰ test (S Ⅰ t).The correlations of measuring outcomes of tear meniscus by anterior segment module of OCT with dry eye-related examinations were analyzed with Spearman correlation coefficients.Results The values of UTMH,UTMD,UMA were (232±56) μm,(156±53) μm,(0.021 ±0.008) mm2,respectively,and the values of LTMH,LTMD,LMA were (222 ± 72) μm,(163 ± 65) μm,(0.020 ± 0.006) mm2,respectively.No significant differences were found in the measuring values between the upper and the lower tear meniscus (all at P＞0.05).The quantitative values of tear meniscus were not significantly correlated with the OSDI scores or tear film interferometry grade.Significant correlations were seen between UTMH,UTMD,UMA and BUT (r=0.46,P=0.01 ;r=0.40,P=0.02;r=0.43,P=0.01).LTMH,LTMD,LMA were positively correlated with BUT (r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00) and S Ⅰ t (r=0.54,P=0.02 ;r=0.46,P=0.01;r=0.55,P=0.01) as well as negatively correlated with fluorescein cornealstaining (r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P =0.05) and lissamine green conjunctival staining (r =-0.56,P =0.01 ; r =-0.37,P =0.04 ; r =-0.47,P =0.00).Conclusions Anterior segment module of OCT is an effective approach to the measurement of tear meniscus.The measuring outcomes of anterior segment of OCT are associated with dry eye-related signs.

ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.

Objective To investigate the expression of TLR2 and HIF-1α in pancreatic cancer and explore the relationship between TLR2 or HIF-1α protein and the clinical or pathological changes in pancreatic cancer. Methods The mRNA of TLR2 and HIF-1α in 30 cases of pancreatic cancer and its adjacent tissues were detected with real-time PCR and with immunohistochemical methods in 65 cases of pancreatic cancer and 38 cases of corresponding adjacent tissues. The relationship between TLR2 or HIF-1α and pathologic features of pancreatic cancer was analyzed. The correlation between TLR2 and HIF-1α in pancreatic cancer was also assessed. Kaplan-Meier method was used to assess the impact of TLR2 or HIF1αexpression on survival. Results The relative quantification of TLR2 mRNA and HIF-1α mRNA in pancreatic cancer tissues was 0.84±0.17 and 0.87±0.11, respectively, which was significantly higher than that in adjacent tissues 0.70±0.13 and 0.68±0.13 respectively,P＜0.05. The protein expression of TLR2 and HIF-1α in pancreatic cancer tissues was 63. 10% and 70.8%, respectively, significantly higher than that in adjacent tissues (34.20% and 36.8%, respectively). There was no significant correlation between the expression of TLR2 or HIF-1α protein and the age, gender, tumor location, the degree of differentiation in patients with pancreatic cancer (P＞0.05). However, there was significant correlation between the expression of TLR2 or HIF-1α protein and tumor size, lymph node metastasis, venous invasion and clinical staging. TLR2 and HIF-1α had a significant impact on survival. Conclusion TLR2 and HIF-1α overexpressed in pancreatic cancer and TLR2 signaling pathway may promote development of the pancreatic cancer with HIF-1α together.

BACKGROUND:The cervical pedicle screws mistakenly inverted the cervical pedicle could lead to the many complications such as spinal cord,vertebral arteries and nerve root damage.If the parameter of inserting pedicle screws were measured accuracy,the rate of inserting pedicle screws successfully could be improved.OBJECTIVE:To get 3D anatomic parameter of inserting pedicle screws in the cervical vertebrae with the CT three-dimensional recontruction.METHODS:The Dicom data that the cervical vertebrae had been scanned by SIEMENS EMOTION 16 CT were converted into the soft Mimics 8.1,GE workstation and three-dimensional cervical vertebrae were reconstructed.The parameters of inserting cervical pedicle screws were measured with the consideration of the diameter of pedicle screw.RESULTS AND CONCLUSION:The cervical three-dimension images were reconstructed clearly with the CT three-dimensional reconstruction techniques.The cervical pedicular width,the axial length,α and β angles were measured by the soft measure function.The average inserting angular safe range of α angle was gained with the consideration of the diameter of pedicle screw.This method can mimic the operation and it is significant way in measuring the three-dimension anatomic parameter of the cervical vertebrae.The method is a good way that how to insert the cervical pedicle screw safely.

Objective To investigate the relevant mechanism of different concentrations of Shenqi YiliuDecoction medicated serum on blocking cell cycle and inhibiting invasion and metastasis of gastric cancer cell lines MKN-45. Methods Sixty SPF Wistar rats were randomized intoShenqi Yiliu Decoction low-, medium-, and high-dose groups and control group, with 15 rats in each group. Low-, medium- and high-dose groups were fed with different concentrations of TCM liquid from which containing crude medicine (0.25, 0.50, 1.00 g/mL) separately for gavage. Rats in the blank group were given the same amount of drinking water for gavage, twice a day, for 7 days.2 h after the last gavage, rat blood was taken and serum was separated. After MKN-45 cells were dealt with different concentrations of medicinal serum, FCM was used to detect cell cycle and immunohistochemistry technology was used to detect the expressions of COX-2 and PTEM proteins.Results FCM analysis showed that medicated serum could increase G0-G1 phase and shorten S phase of cells; medicated serum could reduce the positive expression rate of COX-2 of the MKN-45 cells and increase positive expression rate of PTEN proteins (P<0.05).ConclusionShenqi YiliuDecoction medicated serum can block the cell cycle and inhibit invasion and metastasis of MKN-45 cell lines, which may be related to the intervention in the expression levels of COX-2 and PTEN proteins.