Objective To discuss the short-term clinical effect of K-Rod pedicle dynamic fixation system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,28 patients with multiple segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system were retrospectively reviewed. The short-term clinical effect were based on Oswestry disability index score,visual analogous scale ( VAS) ,improvement rate of low back pain,postoperative lumbar hyperextension, hyperbend X-ray film lumbar ROM value ( lumbar flexion mobility) ,average operation time, intraoperative blood loss. Results All of 28 cases were achieved 12 ~24 months follow-up,the difference of Oswestry disability index score and visual analogous scale ( VAS) between 12 months postoperatively and preoperatively were statistically significant,the improvement rate of low back pain was (87. 0 ± 2. 0)%,the average operation time was (99. 6 ± 16. 2) minutes,the average blood loss was (70. 5 ± 31. 5)mL,the average length of stay(ALOS) was (11. 2 ± 2. 6) days after sur-gery. Conclusion K-Rod pedicle dynamic fixation system in the treatment of multiple segmental lumbar degeneration can obtain satisfactory short-term clinical effect.

Objective To discuss the clinical effect and the notes of atlas lateral mass screws combined with posterior epistropheus ped-icle screws for the treatment of atlantoaxial joint instability. Methods In our hospital from January 2006 to January 2011,48 cases of atlan-toaxial joint instability accepted operation of the atlas lateral mass screws combined with epistropheus pedicle screws were analyzed. Results All patients with follow-up time 12~24 months,an average of 17 months,were achieved primary healing and atlanto-axial intervertebral osse-ous healing. Besides postoperative neck pillow area pain improved and nerve function get a degree of recovery,there was no inner fixed damage cases. Complications of operation include venous plexus hemorrhage was in 2 cases,cervical occipital pain and numbness increase in 3 cases,cere-brospinal fluid leak in 2 cases,vertebral artery extrusion occlusion after cerebral ischemic symptoms in 1 case. Conclusion Combination of atlas lateral mass screws and posterior epistropheus pedicle screws technique is one of the effective means of treatment of atlantoaxial joint instabili-ty and can obtain satisfactory clinical effect. Standard operation performance is the key to reduce or even eliminate surgical complications.

Objective: To explore weather microRNA let-7c (miR-let-7c) could regulate myotrophin gene expression in rat’s H9c2 cardiac myocytes with possible mechanisms.
Methods: Recombinant plasmid carrying 3′ untranslated region (3′-UTR) of myotrophin and miRNA precursor of let-7c was co-transfected into Hela cells to construct the luciferase reporter system in order to measure luciferase activity. Rat’s H9c2 cardiac myocytes were cultured. The let-7c gene expression was detected by Taqman probe-based real-time PCR after let-7c miRNA precursor or let-7c miRNA inhibitor transfection respectively; protein expressions of myotrophin and nuclear factor-κB (NF-κB) were examined by Western blot analysis.
Results: Luciferase activity examination indicated that compared with recombinant luciferase gene expression carrier (pMIR-MTPN)+miR precursor negative control group, pMIR-MTPN+miR-let-7c miRNA precursor group showed reduced luciferase activity (59.30±9.90) % vs (98.10±15.10) %. Western blot analysis presented that compared with miR negative control group, miR-let-7c precursor group had decreased protein expressions of myotrophin (0.28±0.05) vs (0.90±0.09) and NF-κB (0.25±0.06) vs (0.75±0.07); in contrast, compared with Negative inhibitor group, miR-let-7c inhibitor group had increased protein expressions of myotrophin (1.14±0.09) vs (0.44±0.09) and NF-κB (1.09±0.05) vs (0.71±0.06), allP<0.05.
Conclusion: miR-let-7c could inhibit myotrophin expression via acting on its 3′-UTR domain and may also inlfuence NF-κB signaling pathway in rat’s H9c2 cardiac myocytes.

Objective The purpose was to compare the biomechanical characteristics of new percutaneous guide wire and conventional wire in cadaveric spines,and to evaluate the new percutaneous guide wire's efficacy and safety in a clinical trial.Methods Compared the push-out and penetration forces of the new percutaneous guide wire and conventional wire in fresh cadaveric lumbar spines from L1 to L5.And analyzed the related complications of new percutaneous guide wire by clinical experiment.Results Push-out forces caused the spiral part of the new percutaneous guide wire to bend or spread,so as to resist the anterior migration of the guide wire.The mean push-out forces of the new percutaneous guide wire and conventional wire were (15.5-+ 1.9) N and (5.7 ± 0.8) N respectively (P ＜ 0.01),and the mean penetration forces were (69.1 ±4.2) N and (37.1 ±4.8) N respectively (P ＜0.01).There was no wire breakage or anterior-wall penetration in the clinical trial of 222 new percutaneous guide wire.Conclusion The mean push-out and penetration forces of the new percutaneous guide wire were approximately 2 to 3 times greater than those of conventional wire.The new percutaneous guide wire effectively prevented guide-wire anterior migration and penetration of the anterior vertebral-body wall.The new percutaneous guide wire device could effectively improve the safety of percutaneous pedicle screw insertion procedures for patient with osteoporosis.

Objective Currently there is little study on the K-Rod pedicle fixation system in the treatment of far lateral lum-ber disc hernaition with multiple segment degeneration.The study was to compare the short-term efficay of K-Rod pedicle dynamic fixa-tion system and lumbar fusion for far lateral lumber disc herniation with multiple segment degeneration. Methods Retrospective a-nalysis were made on 56 patients with lumbar intervertebral disc herniation with multiple segment degeneration who received operation in General Hospital of Shenyang Military Region from January 2010 to October 2012.They were divided into K-Rod group (combined treatment of lumbar fusion and adjacent degenerative segment unfusion) and traditional fusion group according to different treatments. 28 patients in K-Rod group were treated with K-Rod pedicle dynamic fixation system and 28 cases in traditional fusion group were trea-ted with traditional lumbar fusion and internal fixation.Comparative analysis were made on the indexes before and after operation be-tween two groups, including Oswestry disability index, visual analogous scale (VAS) ,improvement rate of low back pain, postopera-tive lumbar spine X-ray, operation time, intraoperative blood loss and postoperative average length of stay. Results 12 to 24 months follow-up were achieved on 56 cases.The Oswestry function score and visual analog scale for both groups were improved significantly at 12 months after operation, and the difference was of statistical significance (P<0.05).Oswestry function scores and vis-ual analog scales between two groups were of no significant difference either before operation or after operation (P>0.05), while the average operation time ([119.6 ±14.2] min vs [155.5 ±17.5]min), the average blood loss ([235.5 ±32.5] mL vs [367.5 ±29. 5] mL), the average length of stay (ALOS) ([10.5 ±2.2] vs [14.2 ±2.6]d) between K-Rod group and traditional fusion group were of significant difference(P<0.05). Conclusion In the treatment of far lateral lumber disc hernaition with multiple segment degeneration, the K-Rod pedicle dynamic fixation system atrributes to less intraoperative blood loss, shorter operation time and little postoperative effect on lumbar spine mobility.

Objective The aim of this study was to provide methods for predicting ideal trajectory and position of C1 lateral mass screw (C1 LMS)from plain radiographs.Methods A total of 40 consecutive subjects (with 79 screws)who had undergone C1 LMS placement were enrolled.To evaluate the C1 LMS position,the positions of screw head and tips on anteroposterior radiographs,screw length,and height on lateral radiograph were graded as 0°,Ⅰ°,and Ⅱ°,respectively.On the postoperative computed tomography images,the lateral mass (LM) perforation,screw-thread engagement percent(%),bicortical fixation,extruded screw length,and violation of adjacent joints were analyzed. Results Screws with tip located medial to LM(tip 0)showed LMperforation in all cases.Polyaxial head located within the LM(head 0)or crossing the lateral margin of the LM(head Ⅰ)showed no LMperforation.Screw-thread engagement percent was the highest with head Ⅰ-tip Ⅰ (medial half of LM)position (97.6%),followed by head 0-tip Ⅰ (90.5%)and head Ⅰ-tip Ⅱ (lateral half of LM)(86.4%). Screws longer than the posterior half of C1 anterior arch (AA)showed bicortical fixation in all cases with mean extruded screw length of 1.9 mm.Adjacent joint was not violated in 98%,with the screw height below half of C1 AA.Conclusion On an anteroposterior radiograph, a C1 LMS with the screw head located on the lateral margin of the LMand with the screw tip in the medial half of the LMresulted in the safest and longest trajectory.On lateral radiograph,a screw tip that is placed within the anterior-inferior quadrant of the C1 AA results in safe bicorti-cal fixation without injury to the adjacent structures.These plain radiographic findings may be helpful bothpostoperatively and intraoperatively for assessing the trajectory and length of the screw.

Clinical testing of equipment is an interdisciplinary professional and technical course,of which we made continuous innovation and practice by optimizing the curriculum system ,upgrading teaching contents,reforming teaching methods,opening up the construction of teach-ing materials,building the teaching staff and improving teaching quality management etc.After five years of positive efforts the remarkable teaching results were achieved.

By updating their concepts of education,carrying out the reform of teaching content,teaching methods and means,strengthening the construction of teaching materials,creating a high standard teaching team,the author aims to implement the construction of quality course of clinical testing equipment and comprehensively improve the teaching quality.

Forty-two patients with type 2 diabetes mellitus (DM) were refered to 3 groups:type 2 DM without diabetic nephropathy (DN),type 2 DM with DN in the initial stage and type 2 DM with DN in the clinical stage.Ten healthy subjects were served as control group.Plasma adrenomedullin (ADM),urinary?_1- microglobulin (MG) and?_2-MG were detected.The results showed that the level of plasma ADM rose gradually with the development of DN and was positively correlated with markers of tubulointerstiial injury such as urinary?_1- MG and?_2-MG (both P

Pancreatoblastoma is a rare kind of malignant tumor of pancreas,which is commonly seen among children.A female child aged 5 years was admitted to the Dapiag Hospital with the chief complaint of painless abdominal mass on June 18,2010.The results of B ultrasound showed acoustic shadow of tumor calcification and an absent of normal pancreatic echo.The results of computed tomography(CT)showed that the tumor was located at the body and tail of the pancreas with a low-density and isopycnic shadow of intermixed huge block.The parenchyma of tumor showed unequal enhancement,the periphery showed lobular-like reticular enhancement,the central necrotic area showed no enhancement,and multiple metastatic foci were observed in spleen and liver under enhanced CT scan.The patient underwent resection of the body and tail of the pancreas and the spleen.Chemotherapeutics with vincristine,cyclophosphamide and doxorubicin were adopted postoperatively.After a period of 6-month follow-up,the results of CT showed that the size of tumor was decreased.