BACKGROUND:It is difficult to expose bilateral facet joints in L5 spondylolysis patients compared with non-spondylolysis patients. Thus, vertebral facet joint spacing and height in L5 spondylolysis patients can be used as indirect diagnostic signs that play key roles in the diagnosis of spondylolysis.
OBJECTIVE:To analyze the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra and the relationship between the lumbar spondylolysis and the relative spacing of articular process.
METHODS:(1) Analysis of anatomical structure characteristics and diagnostic methods of lumbar spondylolysis:The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra in diagnosing feasibility of lumbar spondylolysis was analyzed. (2) A total of 23 patients with L5 spondylolysis from Department of Orthopedics, Puyang Oilfield General Hospital and 30 normal controls were col ected from April 2013 to February 2015. The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra was measured between the two groups.
RESULTS AND CONCLUSION:(1) The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra reflected that the occurrence of L5 spondylolysis was probably associated with the width of L5 vertebral facet joint spacing. (2) Clinical trial results showed that the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra in L5 spondylolysis patients was higher than normal controls. (3) Results indicate that the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra reflects the occurrence of L5 spondylolysis.

Objective To determine risk factors and treatments of capillary leak syndrome (CLS) in infants with congenital heart disease(CHD)after extracorporeal bypass (GBP) . Method A retrospective study of 38 infants with CIS and another 150 cases without CLS of a random choice who underwent extracoiporeal bypass from June 2003 to July 2007 was carried out.Several risk factors with statistical significance were screened out with uni-varite logistic regression analysis, and the independent rask factors of CLS were determined with inultivariate step-wise logistic regression analysis. The outcome of CIS infants was compared with infants of control group. Results Logistic analysis showed the risk factors of CLS were the duration of GBP ( OR = 10. 353) , type of CHD ( OR = 6. 912), age ( OR = 6. 254) and temperature of CBP ( OR = 4. 151) . Of the CLS infants cohort, 10 cases underwent peritoneal dialysis and 4 cases died. Conclusions The risk factors of CLS in infants after CBP are the length of time consumed during CBP, type of CHD, age and temperature of CBP.

Objectives:To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs).Methods:From January 2015 to January 2016,47 patients(14 males and 33 females) with OVCFs were enrolled in this study.The patients were 53-89 years old (66.4±6.5 years),36 cases were single segmental vertebral fracture,11 cases were double segment vertebral fracture.T9 fracture occured in 7 cases,T10 fracture in 7 cases,T11 fracture in 9 cases,T12 fracture in 13 cases,L1 fracture in 12 cases,L2 fracture in 9 cases,and L3 fracture in 1 case.The fluoroscopy time and bone cenent dosage were recorded.The VAS score,ODI,relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation.The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed.Results:The average fluoroscopy time was 1.6±0.3nin,the average bone cement dosage was 6.7±1.2ml.Bone cement leakage occured in 11 cases with the rate of 23.4％.The patients were followed up for 3-12 months (6.5±1.3 months).The VAS,ODI,the relative height of injured vertebra and the local Cobb angle before operation,at 2 days after operation and final follow-up were:7.6±1.3,(71.4±3.2)％,0.48±0.21,15.5°±4.2°;2.2±1.0,(27.2± 2.6)％,0.82±0.17,7.2°±2.8°;1.7±0.7,(26.5±2.7)％,0.80±0.15,7.5°±3.7°.At 2 days after operation and final follow-up,the VAS score,ODI score,the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation (P＜0.05);There was no significant difference between 2 days after operation and final follow-up(P＞0.05).Conclusions:The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time,even distribution of bone cement,and less leakage.

BACKGROUND:Due to the puncture and difficult reduction, severe vertebral compressive fracture is considered to be the relative contraindication of vertebroplasty and kyphoplasty. OBJECTIVE:To investigate the vertebra reduction after the treatment of severe vertebral compressive fractures with percutaneous kyphoplasty. METHODS:Thirty patients (42 vertebral bodies) with severe compressive fractures were included. The compressive rate of the affected vertebral bodies was 75%-83%. The direction of percutaneous puncture was guided under digital subtraction angiography, and then postural reduction and local kyphoplasty were performed. After satisfactory reduction, bone cement was injected. RESULTS AND CONCLUSION:Al the 30 patients tolerated procedure wel . The mean height of the anterior, mid and posterior vertebral body was improved from (0.48±0.17) cm, (0.83±0.23) cm and (2.44±0.33) cm preoperatively to (0.71±0.22) cm, (1.21±0.25) cm and (2.44±0.33) cm respectively after operation. The postoperative height of the anterior, mid and posterior vertebral body was significantly higher than that before operation. The visual analogue scale score after treatment was significantly lower than that before operation. The results indicate that percutaneous kyphoplasty can ease pain, restore vertebral body height and improve quality of life of the patients with severe vertebral compressive fractures.

Objective To evaluate the influence of platelet-rich plasma (PRP) on autologous fat grafting breast augmentation surgery.Methods A lot of 40 patients were divided randomly into the treatment group and control group, each group of 20 cases.In the treatment group cases PRP was used in addition to autologous fat grafting.Chest circumference and thickness of subcutaneous fat were measured before and 6 month after operation and 12 months later.The results were compared and the influence of PRP was evaluated after operation.Results Both groups of patients were satisfied with the results.Compared with the control group, patients in the treatment group showed the chest circumference and thickness of subcutaneous fat were significantly increased 12 months after operation.Conclusions The efficacy of PRP is significant in enhancing fat graft, reducing fat absorption in 12 mouths after operation.The fat tissue mixed with PRP is a reliable reconstruction option for the breast augmentation.

Objective To investigate the characteristics and risk factors of abdominal lymph node metastasis in thoracic esophageal squamous cell cancer.Methods The clinical data of 586 patients with thoracic esophageal cancer who underwent surgery via transabdominal and transthoracic approaches between June 2009 and June 2014 at the Sichuan Cancer Hospital were retrospectively analyzed.All the patients received resection of esophageal cancer and lymph node dissection, and the transabdominal right thoracic approach or cervico-thoracicabdominal triple incision was selected according to the condition of patients.No.18, 19, 20 lymph nodes were dissected seperately and No.16, 17 and lesser curvature lymph nodes were separated.All the specimens of lymph nodes were detected by regular pathological examination.Measurement data with normal distribution were presented as x ± s and count data were described as rate.Comparisons of rate between 2 specimens and among the multiple specimens were respectively analyzed using the chi-square test and partition of chi-squared.The multivariate analysis was done using the logistic regression.Results The number of lymph node dissected in 586 patients was 12 524 with an average number of 20 ± 11 per case, and the rate of lymph node metastasis was 55.63％ (326/586).The number of mediastinal lymph node dissected was 7 012 with an average number of 12 ± 5 per case, and a rate of mediastinal lymph node metastasis was 40.96％ (240/586).The number of abdominal lymph node dissected was 5 512 with an average number of 9 ± 8 per case, and a metastasis rate was 31.74％ (186/586).The abdominal lymph node metastasis rate of the upper, middle and lower thoracic esophageal cancer were 13.73％ (14/102), 31.51％ (92/292) and 41.67％ (80/192), respectively, showing a significant difference among the above 3 indexes (x2 =25.91, P ＜ 0.05).The lymph node metastasis rate in No.16, 17, 18,19, 20 and lesser curvature lymph nodes were 12.80％ (75/586), 16.89％ (99/586), 1.71％ (10/586),0.68％ (4/586), 1.71％ (10/586) and 2.05％ (12/586), respectively, with a significant difference among the above 6 indexes (x2 =287.95, P ＜ 0.05).The results of univariate analysis showed that the tumor location,surgical procedure, T stage, N stage, G stage, pathological stage and mediastinal lymph node metastasis were risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer (x2 =24.02, 23.97, 37.87,136.85, 38.79, 7.70, 154.27, P ＜ 0.05).The tumor in the lower thoracic portion, N3 stage and stage Ⅳ were independent risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer in the multivariate analysis (RR =5.80, 2.36, 2.76, 95％ confidence interval: 1.022-1.813, 1.317-3.950, 1.652-12.351, P ＜ 0.05).Conclusions Abdominal lymph node metastasis is common in thoracic esophageal cancer in which No.16 and 17 lymph nodes predominate, and it is easy to occur in patients with lower thoracic esophageal cancer, and advanced N stage and pathological type.

Cerebral ischemia tolerance was induced by exercise preconditioning, which protected the brain from injury. The detailed mechanism of exercise preconditioning protecting cerebral ischemia injury was complicated, which involving the regulation of multiple tar-get point and multi-path, such as inhibiting cell apoptosis, promoting angiogenesis in the brain, inhibiting the excessive activation of glutam-ic acid as well as the regulation of inflammation. More mechanisms were still unknown.

BACKGROUND: Biliary tract complications are one of the most common postoperative problems after liver transplantation.Balloon dilation and percutaneous transhepatic biliary drainage (PTBD) has become an effective method to improve biliary complication after orthotopic liver transplantation (OLT).OBJECTIVE: To evaluate the balloon dilation and PTBD in the treatment of biliary stricture after OLT through case follow up.DESIGN, TIME AND SETTING: A total of 53 consecutive patients underwent interventional procedures to treat biliary stricture after OLT in the Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University from July 1999 to March 2007 and were recruited for this study. The series included 46 men and 7 women, with 17-64 years of age. After OLT transplantation, all patients had abnormally elevated serum bilirubin level, and confirmed to suffer from obstruction of biliary tract by CT or MRI examinations.METHODS: Of 50 patients who received PTBD treatment, 36 underwent PTBD through right bile duct, 14 underwent bilateral (right bile duct and left bile duct) PTBD with 6 patients through left bile duct in the second treatment. A total of 13 underwent balloon dilation, and 3 were subjected to balloon dilation alone.MAIN OUTCOME MEASURES: An averaged 9.6 months of follow up was performed in 53 patients to observe obstructive jaundice recurrence induced by abnormally elevated serum bilirubin level after percutaneous transhepatic biliary interventional procedures.RESULTS: Follow up results showed satisfactory clinical outcome with obstructive jaundice resolved in all patients, except one patient, who received treatment with T tube, died of acute rejection at month 1 during the follow up, and one patient with liver failure had extremely poor prognosis after discharge at month 1 during the follow up. Obstructive jaundice was recovered even healed and serum bilirubin level was decreased to normal level in 51 patients at the end of follow-up. Primary success rate was 79% (42 in 53 cases), and assisted success rate was 21%. The first interventional procedure failed to treat obstructive jaundice in 5 patients. Obstructive jaundice recurred after primary percutaneous procedure in other 6 cases. No procedure related severe complications happened.CONCLUSION: Balloon dilation and PTBD are safe to treat biliary tract complication after OLT, without complication.

Objective To explore effect of Xylazine hydrochloride on Bama minipigs under general anesthesia. To emphasize safety consciousness of general anesthesia. To research cardiac main function and structure of normal Bama minipigs in preparation for the subsequent comparative medicine research. Methods 43 Bama minipigs, inject in post aurem muscles of neck with 5 mL of mixed drug conclude Xylazine hydrochloride (2 mL), Atropine Sulfate(1 mL) and Droperidol(2 mL) on each one. Echocardiography after general anesthesia. Observe induction and recovery time of anesthesia, anesthesia maintaining time, total check time and the others. Introduce the method of simple endotracheal intubation. Results Anesthesia, induction period (18 ±3)min, maintaining period (40 ±5)min, recovery period (60 ± 10)min. Echocardiography, LAD (2?54 ± 0?20) cm, LVDd (3?41 ± 0?25) cm, LVDs (2?28 ± 0?23) cm, IVSTd (0?60 ± 0?07) cm, LVPWTd (0?59 ± 0?07) cm, AoD (1?77 ± 0?18) cm, EDV (48?59 ± 8?31) cm, ESV (18?28 ± 4?46) mL, SV ( 39?30 ± 5?16 ) mL, LVEF ( 62?76 ± 5?01 )%. Conclusions Intramuscular injection of xylazine hydrochloride with droperidol and atropine sulfate on bama minipigs for general anesthesia is a highly conserved specie in cardiovascular system and safe. We obtained some information of cardiac main function and structure of normal Bama minipigs which could provide reference for scientific research and veterinarian clinic.

Objective This study was performed to assess the clinical feasibility of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer.Methods Between March 2011 and May 2012,we retrospectively analyzed the data from 56 patients who underwent video-assisted mediastinoscopic lymphadenectomy(VAMLA).In patients receiving tumour resection subsequently,radicality of the previous mediastinoscopic dissection was controlled during thoracotomy.Results Mean operative time of video-assisted mediastinoscopic lymphadenectomy was(42.0 ± 13.5) min(range of 26-86 min).Mean number of resected lymph nodes was 12.4 ± 6.7 (range of 5-24).In video-assisted mediastinoscopic lymphadenectomy,the rates of lymph node dissection of stations 2,4,5,7,8 were 54.5％,92.7％,58.2％,100％,61.8％,respectively,there was no operative mortality and morbility.90.9％ patients achieved radical dissection.Conclusion Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure and provides more accurate staging of mediastinal node in lung cancer patients.It also plays an important role in minimal invasive surgery and neoadjuvant therapy.