aused by the wrong maneuvers by inexperienced operators.

Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.

Objective To compare the lateral decubitus and supine position in the treatment of femoral intertrochanteric fractures with femoral proximal nail antirotation (PFNA).Methods A retrospective analysis was performed of the 85 patients with intertrochanteric fracture who had been treated at our hospital between September 2013 and September 2014.They were 24 men and 61 women,28 to 99 years of age (average,78.5 years).By Evans-Jensen classification,one case was type Ⅰ,15 cases were type Ⅱ,40 type Ⅲ,23 type Ⅳ,and 6 type Ⅴ.All the patients were treated with internal fixation with PFNA.Lateral decubitus position was adopted in 45 cases and supine position in 40.The 2 groups were compared in terms of operation time,intraoperative bleeding volume,difference between preoperative and postoperative hemoglobin values,tip-apex distance (TAD),calcar tip-apex distance (Cal-TAD),fracture healing time,and Harris score of the hip joint.Results The 85 patients were followed up for 9 to 21 months (average,13.6 months).Both 2 groups obtained fracture healing,with no screw cut-out.The lateral decubitus group had significantly less operation time (60.3 ± 17.5 min) and intraoperative bleeding volume (70.8 ± 37.8 mL) than the supine position group (72.7 ± 19.7 min and 90.3 ± 20.9 mL,respectively) (P ＜ 0.05).The former also had a significantly smaller difference between preoperative and postoperative hemoglobin values (24.1 ± 5.7 g/L) than the latter (28.2 ± 8.5 g/L) (P ＜ 0.05).There were no significant differences between the 2 groups in TAD,Cal-TAD,fracture healing time (3.7 ± 0.9 months versus 3.7 ± 1.0 months),or Harris hip score (73.4 ± 10.7 versus 75.5 ± 9.5) (P ＞ 0.05).Conclusion In the treatment of femoral intertrochanteric fractures with PFNA,lateral decubitus position may be associated with shorter operation time and less intraoperative blood loss compared with supine position.

0.05). Conclusion There exist radiological changes in paravertebral muscles in AIS, which may be secondary to AIS and have potential clinical importance on the evaluation of curve progression.

Objective To present the preliminary clinical results of anterior thoracoscopic correction for thoracic idiopathic scoliosis and consider its ind ications. Methods Between June 2002 and May 2003, 8 female patients with a diagn osis of right thoracic idiopathic scoliosis were selected to undergo thoracoscop ic instrumentation, correction and fusion using Eclipse system. The average age at surgery was 14.8 years (ranged from 13 to 16 years). The average preoperative Cobb angle was 54? (ranged fom 40? to 72?). 5 had idiopathic thoracic curves of King type Ⅲ, 2 of King type Ⅱ, and 1 of King type Ⅴ. The Risser sign rang ed from (+++) to (++++). The bending films of the thoracic curves showed a flexi bility of 60%-75%. The thoracic sagittal profiles remained normal without obviou s kyphosis or lordosis. In all cases the rotation of the top vertebra of scolios is was of degree Ⅰ. The operative time, blood loss, postoperative drainage, the number of instrumented levels, curve correction and loss of correction were ana lyzed. Results The instrumented levels were from T5 to T12. The average number o f instrumented levels for each patient was 7.4. The operative time averaged 6 ho urs. The blood loss during surgery averaged 629 ml (ranged from 400 to 800 ml), with no blood transfusions being required, except in one case. The average posto perative drainage was 500 ml. The postoperative Cobb angle was 15? on average w ith curve correction of 74%. With an average follow-up period of 6.5 months (ran ged from 3 to 12 months), the loss of correction averaged 8.3%. No hardware comp lications occurred. Conclusion Compared to the open anterior and posterior surge ry, the thoracoscopic Eclipse instrumentation is a safe and an effective way to correct thoracic idiopathic scoliosis with similar short-term postoperative resu lts. However, challenging issues remain. These included long operative time, hig h technical requirement, relatively limited indication and large radiation expos ure. Again, further research is needed to study its long-term impact.

Objective Explore the value of APM histochemical stain technique in the diagnosis of amniotic fluid embolism(AFE).Method The pulmonary tissues taken from autopsies performed in 1988～2001 including 19 AFE cases and 3 babies died of amniotic fluid aspiratory pneumonia(positive control),10 women in labor died of other causes(negative control) were sectioned again and stained by APM method and HE method. Comparative statistical research was carried out on findings from the 2 staining methods. Results By APM stain,amniotic fluid elements could be found in all AFE cases and positive control cases as well as some negative control cases.In addition,we found 1 positive case neglected and 1 false negative case of AFE retrospectively.Statistical comparison revealed that APM stain can elevate the detection rates both for keratinized epithelium and mucus.Conclusion APM staining provided possibility of detecting some amniotic fluid elements that was not distinguished by HE stain. The APM stain is helpful and can be used for AFE diagnosis in routine histological examination.

Survivin, a newly identified member of IAP family, is a powerful apoptosis-inhibiting factor. It is expressed in embryonic tissues as well as in the majority of human cancers, but not in most normal adult tissues. The cancer-specific expression of survivin makes it a potential target for cancer treatment. A survivin-specific small inhibitory RNA (siRNA) was introduced into hepatocellular carcinoma cells to investigate its effect on cancer cell apoptosis, growth and sensitivity to chemotherapeutic drugs. It was found that expressions of survivin protein and proliferation index (PI) in siRNA groups were significantly decreased, the apoptosis index (AI) of siRNA groups was significantly higher than those of others groups, and the growth inhibition rate (GIR) of chemotherapeutic drugs in siRNA groups were significantly higher than those of other groups. Our study suggests that the expression of survivin may be significantly decreased in hepG2 cell after siRNA transfection. siRNA targeting survivin could induce cell apoptosis, inhibit cell proliferation and sensitize hepatocarcinoma cells to chemotherapy. Our findings provide preliminary evidence for the therapeutic use of survivin-targeted RNA interference for human tumors that express high levels of this molecule.
Apoptosis ; Cell Proliferation ; Gene Knockdown Techniques ; Hep G2 Cells ; Microtubule-Associated Proteins/*genetics ; Microtubule-Associated Proteins/metabolism ; RNA Interference ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; RNA, Small Interfering/*genetics ; RNA, Small Interfering/metabolism

To explore the impact of middle and low dose atorvastatin on peripheral endothelial progenitor cells (EPCs) in patients with acute myocardial ischemia injury via investigating EPC proliferation, migration, differentiation and secretion of cytokines. Method: A total of 80 patients with acute ST-segment elevation myocardial infarction (STEMI) were randomly divided into 2 groups: Observation group, the patients received atorvastatin 40 mg and Control group, the patients received atorvastatin 20 mg. n=40 in each group. The number of circulating EPC, EPC proliferation ability and the secretion of cytokines before and at different time points after drug therapy were examined by means of MTT, flow cytometry and ELISA. Results: The number of EPC was obviously increased with greatly changed migration ability within 2 weeks atorvastatin treatment in both groups. The secretion of cytokines presented that the contents of VEGF, bFGF, CXCR were elevating first followed by reducing thereafter, while the content of SIRT1was continuously increasing during the period of treating. The above parameters were similar between 2 groups. Conclusion: Middle and low dose atorvastatin could effectively improve EPC proliferation and migration, increase the expressions of CXCR4, VEGF, bFGF and SIRT1 in STEMI patients.

Objective To explore the method of 3D reconstruction of major blood vessels around the pancreas with Myrian system and its clinical significance.Methods By making use of the data from 64-slice CT of GE,the main arteries,portal vein,spleen vein,superior mesenteric vein and inferior mesenteric vein of 60 pancreases were 3D reconstructed with Myrian system.Vessel length and some other data were also recorded.Results The main arteries and veins were reconstructed.The length of portal vein was (46.37 ± 11.48)mm.The length of postpancreas trunk was (34.88±9.13)mm.The angle between portal vein and spleen vein was acute angle in 17 cases (28.33％),right angle in 11 cases (18.33％) and obtuse angle in 32 cases (53.33％).The inferior mesenteric vein fed into spleen vein in 19 cases (31.67％),superior mesenteric vein in 34 cases (56.67％) and conjunction point between spleen vein and superior mesenteric vein in 7 cases (11.67％).Conclusion Myrian system can be used to reconstruct the 3D structure of blood vessels around the pancreas with high reconstruction rates.This method can also be used in feasibility analysis of clinical operations and reduce the risk of bleeding caused by unknown distribution of blood vessels around the pancreas during operation.

Objective To investigate the value of emergency interventional embolization in the treatment of traumatic splenic rupture.Methods Clinical data of 45 patients with traumatic splenic rupture in our hospital were analyzed retrospectively.Selective splenic artery embolization (embolization group) was performed in 29 patients guided by DSA,and surgical resection or repair operation (operation group) was performed in 16 patients.Results Data of two groups were compared:①For operation time and length of hospital stay,the intervention group was significantly better than the operation group (P<0.05);②For incidence of postoperative fever and pleural effusion,the operation group was lower than the intervention group (P<0.05);③For the postoperative abdominal pain index,there was no significant difference between the two groups (P>0.05);④Compared with the operation group,patients in the intervention group had less long-term complications,and did not require long-term anticoagulation therapy.Conclusion Interventional embolization in the treatment of traumatic splenic rupture is safe and effective, and has less postoperative complications.The interventional embolization improves spleen preservation rate and improved the life quality.