Objective To explore clinical results of posterior spinal approach microendoscopic disectomy(MED) for the treatment of lumbar disc herniation in adolescents.Methods A total of 25 consecutive patients treated by MED from February 2000 to August 2004 in this hospital were analyzed retrospectively.Clinical results were assessed with the modified Macnab criterion.Pre-and post-operative symptoms and functional states were evaluated by the Chinese version Oswestry Disability Index(ODI).Results A conversion to open procedure was required in 1 patient.The operating time was 35～65 minutes(mean,44.8?9.0 minutes);the estimated blood loss during operation was 30～80 ml(mean,51.3?14.6 ml);the postoperative hospital stay was 6～10 days(mean,7.5?1.0 days).All incisions healed by first intention.There were no dural tears,nerve root injuries,intervertebral space infections,or great vessel injuries.Twentg-two patients were followed for 7～57 months(mean,33.4?17.8 months).There were significant differences between preoperative ODI(46.2%?8.5%) and postoperative ODI(1.8%?3.0%).The improvement rate of ODI was 44.4%?9.2%(t=21.61,P=0.00).Clinical results assessment by the modified Macnab criterion revealed "excellent" in 19 patients and "good" in 3 patients,the rate of excellent or good results being 100%. Conclusions Microendoscopic disectomy can be performed safely and effectively for lumbar disc herniation in adolescents,resulting in little trauma,fast recovery,and excellent clinical results.

Objective:To screen and characterize the common epitopes recognized by monoclonal antibody 3A8,which binds several kinds of Gram negative bacteria,which were recognized by monoclonol antibody 3A8 agaisnt different strains of LPS.Methods:Phage clones binding to 3A8 were screened from C7C phage displayed peptide library,the attached phage clones were eluted by LPS2630(O111:B4).After 3 rounds of panning,the positive phage clones were identified by ELISA,and the amino acid sequences of these positive clones were deduced from DNA sequences.In order to predict how these peptide mimics interaction with 3A8,peptides(A2 and A5) based on conserved sequences of positive clones were synthesized and conjugated with KLH for further study.The binding of A2-KLH and A5-KLH to 3A8 were identified by ELISA.Results:15 of 33 phage clones were identified as positive clones and shown specific binding with 3A8.LPS2630 potently inhibited the binding of phage clone to 3A8.In analysis of the amino acid sequence,there were seven kinds of sequences containing highly hydrophilic residues,and Ser Pro Pro/Pro X Pro was the conserved sequence.The peptides A2 and A5 could bind to 3A8 specially.Conclusion:The conserved sequences containing Ser Pro Pro/Pro X Pro are obtained,which are recognized by mAb 3A8 against broad spectrum Gram negative bacteria and several strain LPS.The synthetic peptides based on the conserved sequence can bind to 3A8,indicating that the peptides can mimic a common epitope of Gram negative bacteria,which be expected as candidate epitope for vaccinization.

Objective To explore the clinical application value of early bundle therapy in patients with septic shock after per‐cutaneous nephrolithotomy(PCNL) .Methods The retrospective analysis was conducted patients with septic shock after PCNL ad‐mitted to the central ICU of the First Affiliated Hospital ,University of South China from January 1st ,2011 to september 30 ,2013 . The patients were divided into non‐bundle therapy group and bundle therapy group according to whether treated by early bundle therapy .the APACHE‐Ⅱscore and SOFA score in the before and 1 ,3 ,7 d after treatment ,mortality rate within 28 d and length of ICU were compared with both groups .Results 54 patients were enrolled in the study ,there were 28 and 26 patients in non‐bundle therapy group and bundle therapy group ,respectively .The clinical data of patients in both groups had no significant difference be‐tween the groups ,all P>0 .05 .Compared with the patients in non‐bundle therapy group ,the APACHE‐Ⅱscore and SOFA score in 1 ,3 ,7 d after treatment significantly decreased in bundle therapy group ,all P<0 .05 .mortality rate in bundle therapy group and non‐bundle therapy group were 15 .38% and 35 .71% ,respectively ,P<0 .05 ;and length of ICU were(9 .04 ± 4 .48)d and(7 .00 ± 2 .32)d ,respectively ,P<0 .05 .Conclusion Early bundle therapy can effectively alleviate the severity of the disease and reduce mor‐tality of patients with septic shock after PCNL .

Periodontitis is one of the most common oral diseases in humans. As the initiating factor of periodontitis, dental plaque bacteria, is the primary factor leading to periodontitis. Quorum-sensing system relies on quorum-sensing signaling molecules to regulate and strengthenthe communication between different kinds of bacteria, strengthen the communication between bacteria, and promote the occurrence and development of diseases. Quorum-sensing system also plays an important role in promoting the formation of dental plaque biofilm by dental plaque bacteria. In recent years, many studies have shown that quorum-sensing inhibitors can effectively attenuate quorum sensing between bacteria and inhibit and reduce the formation of plaque biofilms between bacteria and the expression of their virulence factors. In this paper, we will review the progress of research on the effects of quorum-sensing signaling molecules on periodontitis pathogens.

Objective To investigate the effects of open reduction and internal fixation plus calcium sulfate artificial bone graft for the treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures.Methods Thc clinical data of patients with Sanders type Ⅲ and Ⅳ calcaneal fractures treated from January 2012 to December 2015 were retrospectively reviewed by case-control study.The patients were divided into two groups as bone graft group (open reduction and internal fixation combined with artificial bone graft) and control group (open reduction and internal fixation).The bone graft group was composed of 17 cases,among which there were 12 males and five females with age range of 19-62 years [(41.6 ± 12.9) years].In bone graft group,there were 12 cases of Sanders Ⅲ and five cases of Sanders Ⅳ.The control group was composed of 13 cases,among which there were eight males and five females with age range of 20-59 years [(39.4 ± 11.8) years].In control group,there were ten cases of Sanders Ⅲ and three cases of Sanders Ⅳ.The follow-up visits were done at 1,2,3,6,and 12 months after surgery with record of complication occurrence.The changes of Bohler's angle and Gissan's angle were observed preoperatively as well as at 2 days and 12 months after surgery.The function recovery was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) score at final follow-up visit.Results Five cases of marginal necrosis of the incision and two cases of superficial soft tissue infection were seen in bone graft group,while there were two cases of marginal necrosis of the incision and one cases of superficial soft tissue infection in control group.In early postoperative comparison between two groups,the variation of Bohler's angle and Gissan's angle had no significant difference (P ＞ 0.05).At 12 months after surgery,Bohler's angle of bone graft and control groups were (23.2 ± 9.0) ° and (19.5 ± 11.1) °,respectively.The losses of Bohler's angle were (3.6 ± 2.7) ° and (6.9 ± 3.1) °,respectively.The difference in the losses of angle in two groups had statistical significance (P ＜ 0.05).Gissan's angle of bone graft and control groups were (123.4 ± 9.4)o and (122.2 ± 9.0)°,respectively.The losses of Gissan's angle were (2.8 ± 1.8) °and (3.8 ± 2.3) °,respectively (P ＞ 0.05).At the final follow-up,bone union was found in all cases,and there was no significant difference in AOFAS score between the two groups (P ＞ 0.05).Conclusions Open reduction and internal fixation can attain good treatment results for Sanders type Ⅲ and Ⅳ calcaneal fractures,no matter whether bone graft is carried out.However,artificial bone graft may have good effects to sustain the stability of fracture fragments and provide early mechanical support for the subtalar joint.

This study was aimed to explore the curative effect of Zhuo-Du-Qing (ZDQ) particles on diabetic cystopa-thy (DCP) based on the theory of turbid toxin. A total of 100 DCP patients were randomly divided into the control group with 47 cases and the treatment group with 53 cases. Mecobalamin tablets was given in the control group. And ZDQ particles were given to the treatment group. The treatment course was 3 months. The observation was made on the bladder residual urine (BRU), clinical manifestation integral, hemodynamic indexes, HOMA-IR and HbA1c before and after the treatment. The results showed that compared with pretreatment, the BRU, clinical manifestation integral, hemodynamic indexes, and HOMA-IR were significantly reduced (P < 0.01). Compared with the control group, the BRU, clinical manifestation integral, hemodynamic indexes, and HOMA-IR were also significantly reduced (P <0.01). The effective rate in the treatment group was 81.1%, which was significantly higher than 59.6% in the control group (P< 0.05). There were no obvious changes on the blood routine examination, urine routine examination, stool routine examination, liver function, renal function, electrocardiogram and so on before and after treatment. It was con-cluded that the treatment of DCP with ZDQ particles was safe and effective. To remove toxin and descend turbid may be another effective treatment method for DCP. The occurrence and development of DCP were closely related to the turbid toxin.

Objective To evaluate whether the patients with Parkinson′s Disease (PD) having higher occurrence rate of frac-ture .Methods CMB ,CNKI ,PubMed ,Embase ,Web of Science ,Medline ,Embase and Cochrane Library were retrieved ,meanwhile which was assisted by the manual retrieval .The retrieval time was until February 2017 .The cohort studies on the occurrence rate of fracture in PD patients were collected .Then the included studies were analyzed after the data extraction and treatment evaluation . Results A total of 1160 articles were retrieved ,finally 11 cohort studies were included ,involving 988723 subjects .The analysis showed that the fracture occurrence risk in PD patients was significantly higher than that in the control group (RR=2 .09 ,95% CI:1 .91-2 .28) ,in which the occurrence rate of hip fracture was significantly higher than that in the control group (RR=2 .33 ,95%CI:1 .79-3 .02) ,while the occurrence rate of spinal fracture had no statistical difference (RR=1 .33 ,95% CI:0 .78-2 .27) ,and the fracture occurrence risk in male and female patients of PD group was significantly higher than that in the control group (RR=2 .40 , 1 .69 ,95% CI:2 .21-2 .60 ,1 .62-1 .76) .Conclusion The fracture occurrence risk in PD patients is significantly higher than that in the control group ,due to existence of certain geographic bias and publication bias risk ,it is needed more high quality clinical stud-ies to accurately evaluate whether the fracture risk in PD patients being much higher .

Objective To compare the clinical efficacy between absolute fixation and bridging fixation in plate osteosynthesis for simple distal tibia fracture.Methods A retrospective case control study was conducted to analyze 41 patients with simple distal tibia fracture admitted to the Chongqing People's Hospital from January 2013 to November 2016.There were 24 males and 17 females,aged 24-70 years [(46.3 ± 13.1)years].According to AO/OTA classification,fractures weres was AO/OTA type 42A1 in 29 cases,type 42A2 in nine cases,type 42A3 in two cases,and type 43A1 in one case.All patients were treated with plate and screw fixation.According to the method of plate fixation,the patients were divided into the locking compression plate (LCP) absolute fixation group (14 patients),the LCP bridge fixation group (12 patients) and the LCP + dynamic double thread locking screw (DDTL) bridge fixation group (15 patients).The patients were followed up by taking anteroposterior and lateral radiographs of tibia and fibula during outpatient visits 1,2,3,6 months and 1 year after operation.The operation time,time to radiological fracture union,time to full weight bearing,callus index and complications were analyzed.Results All the patients were followed up for 12-18 months [(14.5 ± 2.0)months].In the LCP absolute fixation,LCP and LCP + DDTL groups,the operation time was (74.3 ± 15.6) minutes,(78.6 ± 20.1) minutes and (82.5 ± 24.6) minutes,respectively;the time to radiological fracture union was (4.3 ± 1.5) months,(4.5 ± 1.3) months and (4.6 ± 1.4) months,respectively;the time to full weight bearing were (3.4 ± 0.7) months,(3.5 ± 0.6) months and (3.6 ±1.1) months,respectively (all P ＞ 0.05).There was no significant difference in complication incidence among the three groups (P ＞ 0.05).However,the callus index in the LCP + DDTL group (1.19 ±0.13) was significantly higher than that of the LCP absolute fixation group (1.08 ±0.06) and that of the LCP group (1.09 ± 0.09) (P ＜ 0.05).Conclusion For simple distal tibia fracture,both absolute and bridging fixation can attain good fracture union,and LCP combined with DDTL can better promote the formation of callus and facilitate the union.

Objective To analyze the effect of perioperative systemic nursing for laparoscopic radical nephrectomy patients.Methods A total of 90 patients with laparoscopic radical nephrectomy undergoing laparoscopic surgery were randomly divided into observation group and control group,with 45 cases in each group.The observation group used the perioperative whole systematic nursing,the control group traditional nursing.The therapeutic effect,postoperative pain,SAS score,SDS score and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (97.78％ vs.84.44％,P ＜ 0.05);The number of patients with 0,Ⅰ pain was more,and grade Ⅱ and Ⅲ pain patients in observation group were significantly less than that in the control group (P ＜ 0.05);SAS scores and SDS scores of the two groups after treatment decreased compared with treatment before,and the observation group was significantly lower than the control group (P ＜ 0.05);The postoperative complication rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Perioperative systemic nursing measures can improve the curative effect of laparoscopic radical nephrectomy,relieve the pain and negative mood of patients,and reduce the incidence of complications.

Objective To analyze the effect of perioperative systemic nursing for laparoscopic radical nephrectomy patients.Methods A total of 90 patients with laparoscopic radical nephrectomy undergoing laparoscopic surgery were randomly divided into observation group and control group,with 45 cases in each group.The observation group used the perioperative whole systematic nursing,the control group traditional nursing.The therapeutic effect,postoperative pain,SAS score,SDS score and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (97.78％ vs.84.44％,P ＜ 0.05);The number of patients with 0,Ⅰ pain was more,and grade Ⅱ and Ⅲ pain patients in observation group were significantly less than that in the control group (P ＜ 0.05);SAS scores and SDS scores of the two groups after treatment decreased compared with treatment before,and the observation group was significantly lower than the control group (P ＜ 0.05);The postoperative complication rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Perioperative systemic nursing measures can improve the curative effect of laparoscopic radical nephrectomy,relieve the pain and negative mood of patients,and reduce the incidence of complications.