Objective Patients with previous failed scoliosis surgery were managed by revision surgery,the reasons, methods and results of revision surgery were evaluated and analyzed. Methods Thir-ty-six patients with previous failed scoliosis surgery underwent revision surgery between June 1996 and Au-gust 2002. There were 15 males and 21 females with an average age of 16.8 years. The patients had 1.57 operations on average (1 for 27 cases, 2 for 8 cases and 3 for 1 case). The reasons for revision surgery were failure of previous instrumentation (6 cases), deterioration of the deformity (18 cases), and unsatisfactory re-sults with previous surgery (12 cases). Thorough radiographic evaluations including plain X-ray, CT scan and MRI were taken for each patient pre-operatively. The preoperative average Cobb angle for scoliosis was 76.2?(52?-108?)?Of 36 patients, there were 11 with kyphosis and the preoperative average Cobb angle was 53?(36?-79?). The involved spines in the deformity were 10.1 on average (8-13 levels). The surgical proce-dures included removal of previous instrumentation in 21 cases, staged trans-thoracic anterior release in 5 cases with rigid curve, and osteotomy passing through articular joints and laminae on previous fusion mass in 18 cases. All patients underwent trans-pedicular fixation and fusion as well. The clinical and radiographic results were evaluated post-operatively. Results All patients underwent surgery safely. The average opera-tive time was 3.8 hours (2.8-5.1 h) and the average blood loss was 817 ml(630-1 800 ml). There were no serious complications such as neurological injury. The average correction was 48? (22?-64?, 56%) for scolio-sis, and 47? (17?-52?, 72%) for kyphosis respectively. All patients were followed up at least 12 months (12-76 months). There was no loss of correction found during follow up and all patients achieved solid fu-sion. At the last follow up, 33 patients (91.7%) were satisfied with the results of revision surgery. Conclusion Revision surgery for failed scoliosis surgery is challenging because of technical difficulties for the procedure and higher risk for neurological injury. Extreme caution must be taken for each patient during pre-operative examination and evaluation. If appropriate surgical procedure including staged anterior re-lease, posterior osteotomy and trans-pedicular fixation is properly selected according individual deformity, the satisfactory results can be achieved.

Aim: To establish an HPLC method for the determination of 3-methyl-7, 8-dihydroxy-isochroman-4-one in the peel of Musa sapientum. Methods: A column of Shimadzu ODS-C_(18) column (250 mm × 4. 6 mm,5 μm), and a mobile phase of acetonitrile-water-phosphoric acid(9:91:0. 1) were adopted. A detect wavelength of 283 nm, a flow rate of 1 mL/min, and a column temperature of 35 ℃ were set. Results: The content of 3-methyl-7,8-dihydroxy-isochroman-4-one in the peel of Musa sapientum was 0.029 5%-0.036 7%. Calibration curve was linear over the range 1. 09-13. 08 μg. The average recovery was 100. 0%. The assay variability value was 0. 64 %(n=9). Conclusion: The method can be used for the quality control of Musa sapientum.

0.05).By univariate analysis,the diameter of common bile duct less than 10 mm and sphincter of Oddis dysfunction(SOD) and mutiple cannulation of the pancreatic duct were all statistically different(P

Objective To prepared cleavable PEG modified paclitaxel loaded liposome (CLP-PTX) and to study its capability for tumor targeting.Methods Liposome was prepared by film-ultrasonic method.Cellular uptake by HepG2 cells was explored.The anti-proliferation efficiency of CLP-PTX was evaluated by MTF assay.HepG2 cells were xenografted in athymic nude mice to establish the animal models,which were used to evaluate the anti-cancer effect.Results The mean size of CLP-PTX was (95±9.5) nm with the Zeta potential of (-3±1.05) mV,and the entrapment efficiency of PTX was 85.6％.The cellular uptake of liposomes with addition of cysteine (Cys)was 2.8 times as high as that in the absence of Cys,and the difference was statistically significant (P＜0.01).Fluorescent microscopy qualitative observation demonstrated that the cells showed higher fluorescence intensity in the presence of Cys.The MTT assay showed the anti-proliferative activity against HepG2 cells of CLP-PTX depended on the paclitaxel concentration,and the inhibition ratio of CLP-PTX with addition of Cys was 1.6 times as high as that in the absence of Cys (P＜0.01),which was consistent with the cellular uptake results.Conclusions Comparing with paclitaxel,CLP-PTX inhibited the proliferation of HepG2 cells more persistently.Thus,CLP-PTX,as a new nanometer drug,has a special application value for tumor therapy.

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.

Objective To explore the changes of susceptibility of different sides and gender in healthy young adults with quantitative susceptibility mapping (QSM).Methods Totally 41 healthy young right-handed adults underwent conventional brain MRI and QSM scan,and the susceptibility maps were obtained by the image post-processing software.Then the ROI of the bilateral frontal grey matter (FGM),frontal white matter (FWM),caudate (CA),globus pallidus (GP),putamen (PU),thalamus (TH),substantia nigra (SN),red nucleus (RN),dentate nucleus (DN),pons (PO),corpus callosum (CC) were manually drawn to obtain magnetic susceptibility on the susceptibility map.The magnetic susceptibility of each ROI was compare between both sides,as well as gender by Mann-Whitney test.Results The magnetic susceptibility of the bilateral ROI of GP was the highest,and SN was followed,FWM was minimum.The susceptibility of bilateral FGM,FWM,CA,GP,PU,TH,SN,RN,DN,PO,CC had no statistically significant differences (all P＞0.05).The magnetic susceptibility in CA of different gender had statistically significant difference (P＜0.05).Conclusion The brain magnetic susceptibility.can be measured by QSM,and it can assess brain iron content quantitatively.

Objective To investigate the application value of magnetic resonance diffusion tensor imaging (DTI) in auditory pathway of sensorineural hearing loss (SNHL) infants caused by cytomegalovirus (CMV) infection.Methods Thirtyone SNHL infants caused by CMV infections were included,and were divided into bilateral hearing loss (BPHL;n=13) group and unilateral hearing impairment (UPHL;n=18) group (including damaged side [lpsi subgroup] and the undamaged side [contrast subgroup]).Thirty-one infants without hearing loss as control group.The fractional anisotropy (FA),the mean diffusivity (MD),the axial diffusivity (AD) and the radial diffusivity (RD) of bilateral inferior colliculus (IC)and lateral lemniscus (LL) were obtained with DTI technique.The statistical analysis was performed.Results Compared with the control group,the FA value reduced and the RD value increased at LL and IC in the BPHL group (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and the RD value increased at IC and LL in lpsi subgroup (all P＜0.001).Compared with the control group,the FA value reduced at LL in the lpsi subgroup,and FA values reduced and RD value increased at IC (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and RD value increased at LL,and RD value increased at IC in the BPHL group (all P＜0.001).The FA value at IC was negatively correlated with auditory threshold (r=-0.966,P＜0.001).No matter in IC or in LL,the MD and AD had no statistical differences (all P＞0.05).Conclusion White matter of auditory pathway of SNHL infant caused by CMV infection is obviously altered,suggesting white matter myelination or myelin dysplasia.

Objective:To evaluate the efficacy and safety of tazarotene/betamethasone dipropionate cream at different concentration ratios in the treatment of psoriasis vulgaris, and to determine the optimal drug concentration ratio for clinical use.Methods:A multicenter, randomized, double-blinded, multi-dose controlled study was conducted. From December 2008 to April 2009, a total of 180 patients with psoriasis vulgaris were enrolled from 7 research centers, such as Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. These patients were randomly and equally divided into 5 groups: treatment groups 1, 2, 3, 4 treated with tazarotene/betamethasone dipropionate cream at concentration ratios of 0.025%/0.025%, 0.05%/0.025%, 0.025%/0.05% and 0.05%/0.05% respectively once a day, and control group treated with the cream vehicle once a day. The treatment lasted 4 weeks. Efficacy and safety were evaluated after 1, 2 and 4 weeks of treatment. One-way analysis of variance and least significant difference (LSD)- t test were used to compare measurement data among several groups, chi-square test and Fisher′s exact test to compare categorical data among groups, and Cochran-Mantel-Haenszel (CMH) test to compare psoriasis area severity index (PASI) response rates between groups. Results:After 4 weeks of treatment, 11 patients (30.56%) , 12 (33.33%) , 12 (33.33%) , 19 (52.78%) and 2 (5.56%) in the treatment groups 1, 2, 3, 4 and control group respectively achieved a 75% reduction in PASI (PASI75) , and the proportions of patients achieving PASI75 were significantly higher in the treatment groups than in the control group (all P < 0.012 7) . Additionally, the proportions of patients achieving PASI90 were also significantly higher in the treatment groups 1, 2 and 4 than in the control group (all P < 0.012 7) . After 4 weeks of treatment, the rates of reduction in PASI scores were 59.52% ± 26.79%, 57.19% ± 31.98%, 56.85% ± 30.46% and 68.21% ± 37.20% in treatment groups 1, 2, 3, and 4 respectively, which were all significantly higher than the rate of reduction in the control group (20.07% ± 28.55%; LSD- t = 5.36, 5.05, 5.00, 6.55, all P < 0.001) . The treatment group 4 showed marked comprehensive efficacy. All the tested drugs were well tolerated in the patients, and adverse reactions occurred in 11 (30.56%) , 8 (22.22%) , 2 (5.56%) , 4 (11.11%) and 2 (5.56%) cases in the treatment groups 1, 2, 3, 4 and control group respectively. The incidence rate of adverse reactions was significantly higher in the treatment group 1 than in the control group ( P = 0.012) , and there was no significant difference among the treatment groups 2, 3, 4 and control group (all P > 0.05) . Conclusion:The tazarotene 0.05%/betamethasone dipropionate 0.05% cream can be recommended for subsequent clinical trials in psoriasis vulgaris.

Objective:To preliminarily evaluate clinical efficacy and safety of tazarotene 0.05%/betamethasone dipropionate 0.05% cream in the treatment of psoriasis vulgaris.Methods:A multicenter, randomized, double-blinded, single-dummy, parallel-controlled clinical trial was conducted. Subjects with mild to moderate psoriasis vulgaris were randomized into 4 groups at a ratio of 2∶1∶1∶1, including tazarotene 0.05%/betamethasone dipropionate 0.05% cream (Taz/Bp) group, betamethasone dipropionate 0.05% cream (Bp) group, tazarotene 0.05% gel (Taz) group and cream vehicle control (Plb) group. The treatment lasted 4 weeks. After 1, 2 and 4 weeks of treatment, efficacy and safety of drugs were evaluated in the above groups. Two-way analysis of variance model with main effects was used to compare continuous indices, least significant difference t-test was used for multiple comparisons, and chi-square test or Fisher′s exact test for comparisons of categorical data. Results:A total of 300 subjects were enrolled from 7 research centers, including 120 in the Taz/Bp group, 60 in the Bp group, 60 in the Taz group and 60 in the Plb group. After 4 weeks of treatment, proportions of patients achieving a 75% reduction in PASI (PASI75) were 35.83%, 20.00%, 18.33% and 6.67% in the Taz/Bp, Bp, Taz and Plb groups respectively, and there was a significant difference among the 4 groups ( P < 0.05) ; the proportion of patients achieving PASI75 was significantly higher in the Taz/Bp group than in the Plb group (α = 0.05, P < 0.05) and Taz group (α = 0.025, P < 0.025) , but there was no significant difference between the Taz/Bp group and Bp group (α = 0.016 7, P > 0.016 7) ; the proportions of patients achieving PASI90 were 25.00%, 8.33%, 5.00% and 1.67% in the Taz/Bp, Bp, Taz and Plb groups respectively, which significantly differed among the 4 groups ( P < 0.05) , and the Taz/Bp group showed a significantly increased proportion of patients achieving PASI90 compared with the Plb group ( P < 0.05) , Taz group ( P < 0.025) and Bp group ( P < 0.016 7) . All the tested drugs were well tolerated in the 4 groups. Adverse drug reactions occurred in 15 (12.50%) , 5 (8.33%) , 19 (31.67%) and 9 (15.00%) patients in the Taz/Bp, Bp, Taz and Plb groups respectively. The incidence rate of adverse drug reactions significantly differed among the 4 groups ( P = 0.004) , and was significantly lower in the Taz/Bp group than in the Taz group ( P < 0.05) , but insignificantly different between the Taz/Bp group and Bp or Plb group (both P > 0.05) . Conclusion:Tazarotene 0.05%/betamethasone dipropionate 0.05% cream is effective and safe for the treatment of psoriasis vulgaris.

Objective: To study the effect of rhythmic breathing on pain in burn patients. Methods: A total of 100 patients with burns in Tangshan Workers Hospital were randomly selected from August 2015 to August 2017. They were randomly divided into control group and experimental group by random number table method, with 50 cases in each group. Baseline variables were recorded for each patient, and pain scores for each patient was scored on the fourth day after admission by the pain scale questionnaire score. At the same time, from the fourth day of admission, each group began to give sterile dressings to treat burns. The control group only used a conventional care mode that included dressing coverage therapy. The experimental group added rhythmic breathing on this basis. The pain scores were scored on the 5th day, the 6th day, and the 7th day after admission. The pain scores of the 3 days in each group were compared, and the difference in pain scores between the 2 groups was compared. Results: In the experimental group, the pain scores on the 5th day, the 6th day and the 7th day of admission were (1.53±1.90), (1.68±1.37), and (1.97±1.18) points, respectively, and the control group was (3.64±0.85). (3.74±0.78), (3.85±0.81) points, there were significant differences in pain scores between the two groups (U=5.76, 8.65, 7.79, P<0.01). There was no significant difference in pain scores on the 5th day, 6th day and 7th day in the observation group (P>0.05). There was statistically significant difference in pain scores between the control group on day 5, day 6, and day 7 (χ²=6.83, P<0.01). Conclusions Rhythmic breathing relieves pain after burns.