Objective To study the complications of translaminar microendoscopic discectomy and their prevention and management. Methods The complications of translaminar microendoscopic discectomy performed on 487 cases of lumbar disc herniations were retrospectively analyzed. Results Most of the complications were seen in the first 50 cases, which included intraoperative CSF leak (8 cases, 1.64% ), cauda equina damage (1 case,0.21%) nerve root damage (1 case,0.21%) and inflammation of intervertebral disc (1 case,0.21%). Three patients (0.62%) converted into standard open lumbar disc surgery because epidural bleeding was difficult to control under endoscope. Conclusions There is a direct correlation between the compliations and the clinical experience in this technique. The complications of translaminar microendoscopic discectomy at the early stage are significantly higher than those of open techniques, but they are rarely seen at the later stage.

Objective To study the clinical application of posterior approach microendoscopy in the treatment of lumbar spinal stenosis. Methods One hundred and forty-two cases of degenerate lumbar spinal stenosis were treated by posterior approach limited decompression, total or semi laminectomy and decompression, or fenestration decompression from February 2000 to December 2001. Results Out of the 142 cases, posterior approach microendoscopic limited decompression was completed in 87 cases with full decompression obtained.Follow-up for a mean of 18 months in 82 cases revealed a rate of excellent-and-good of 92.7% (58 cases, excellent; 18 cases, good).No complications occurred. Conclusions Degenerate lumbar spinal stenosis, resulted from simple lumbar intervertebral disc herniation, hypertrophy of ligamentum flavumcan, and facet hypertrophy, can be effectively treated by posterior approach microendoscopic limited decompression. Proper selection of patients, full decompression and experienced operative skills are the key to satisfactory surgical results.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

The relationship between plasma level of endogenous secretory receptor of advanced glyeation end products(esRAGE)and oxidative stress in diabetic patients with hypertension was investigated.The results showed that there was significant negative correlation between esRAGE and body mass index(BMI,r=-0.33), diastolic blood pressure(DBP,r=-O.38)and oxidative stress(all P<0.05).The levels of plasma esRAGE decreased significantly in diabetic patients with hypertension.BMI,DBP and oxidative stress may participate in determinining the esRAGE level in diabetic patients complicated with hypertension.

OBJECTIVE To study the Pseudomonas aeruginosas drug resistance in intensive care unit and its fluoroquinolone-resistant molecular mechanism,and provide scientific basis for rational employment of antibiotics in clinic. METHODS E test was used to determine the minimal inhibitory concentrations(MIC) of 13 antibiotics against 83 P. aeruginosa strains. Twenty-eight fluoroquinolone-resistant strains were selected with standard sensitive strain-ATCC27853 as control. The quinolone resistance-determining region(QRDR)of the gyrA and parC genes was amplified by PCR and sequenced. RESULTS The positive rate of P. aeruginosa in sputum specimen was the highest from 83 strains (71.08%). gyrA Genes of all resistant strains had an ACC to ATC mutation in codon 83,leading to the amino acid substitution of threonine for a an isoleucine and 11 high level resistant strains also showed a GAC to GGC mutation in codon 87,leading to the substitution of an aspartic acid a glycine for. In addition,14 resistant strains also had an TCG to TTG mutation in codon 87 of parC gene,leading to the amino acid substitution of a serine for a leucine. We didn't find parC gene mutation existing independent in fluoroquinolone-resistant P. aeruginosa. CONCLUSIONS Meropenem remains highly active against P. aeruginosa. But the abuse of imipenem and other fluoroquinolones leads to rise in their drug-resistance rate. Fluoroquinolone-resistance has increased rapidly,the mechanism of resistance is gene mutant. It displayed that gyrA and parC gene mutation is associated with fluoroquinolone resistance.

OBJECTIVE To study the distribution and drug resistance of the cancer patient′s pathogenic bacteria.METHODS The clinical nosocomial infection of 1451 cancer patients was analyzed by using the soft WHONET-5.RESULTS Of 955 strains isolated from sputa,the G-bacilli were 31.2%,and their main bacteria were Pseudomonas aeruginosa and Klebsiell pneumoniae,the G+ coccis were 31.2%,and their main bacteria were Staphylococcus epidermidis,and the fungi were 43.3%,and their main molds were Candida.albicans.Of 284 strains isolated form stool,the G-bacilli were 64.4%,and their main bacteria were Eschericha coli,the G+ cocci were 10.2% and their main bacteria were S.epidermidis,and fungi were 25.5%.Of 72 strains isolated from blood,the G-bacilli were 62.5%,and their main bacteria were E.coli,the G+ cocci were 30.5% and the fungi were 7.0%.Of 140 strains isolated from pharyngeal swab,the G-bacilli were 15.0%,and the G+ cocci were 43.0% and the fungi were 42.0%.The results of sensitivity tests showed as followed: The G-bacilli had a highly sensitive to imipenem,and had a high drug resistance against the first and second generation cephalosporin,ampicillin,piperacillin.The G+ cocci were highly sensitive to vancomycin and had a high drug resistance against oxacillin,penicillin,and erythromycio,the fungi had an obvious drug resistance against azoles.CONCLUSIONS It is high prevalence of ESBLs among MRS,and Staphylococcus.The application and selection of antibiotics must be based on the results of sensitivity tests,and the drug resistance of pathogenic bacteria must be controlled.

Objective To investigate the correlation between the relapse of condyloma acuminatum(CA)and the potential capability of tumor necrotic factor (TNF) production of the host′s peripheral blood leukocytes. Methods Forty-two CA patients and 58 normal controls were enrolled in this study. CA relapse was diagnosed clinically. EB virus-transformed B lymphoblastoid cell line(LCL)were used as TNF producing cells. The TNF producing capability of LCL was measured by bioassay using L929 (a TNF sensitive tumor cell line) as target cells. The LCL were stimulated with LPS to produce TNF. Results The average level of TNF production of LCL from all CA patients (including recurrent and non-recurrent CA patients) was similar to that of normal controls (30.14% ? 12.27 vs 34.06% ? 12.06,P = 0.1136). However, the level of TNF production of LCs from recurrent CA patients was significantly less than that from non-recurrent CA patients (24.75% ? 7.51 vs 36.62% ? 10.96,P = 0.00016). Compared with that of normal controls, recurrent CA patients showed a lower capability to produce TNF (24.75% ? 7.51 vs 34.06% ? 12.06,P = 0.00054), whereas non-recurrent CA patients showed a similar capability to normal controls (36.62% ? 10.96 vs 34.06% ? 12.06,P = 0.3517). Conclusions These results indicate that the cellular immune mechanism might play an important role in the clearance of the residual HPV from the host, in which TNF is involved.

AIM To study the effects of quateranary ammonium salt derivative (F 2) of haloperidol on ischemia and reperfusion injury in rat hearts. METHODS Ischemia and reperfusion injury in rat hearts was induced by occluding the left anterior descending coronary artery for 30 min and restoring blood reperfusion for 30 min. F 2 (1, 2, 4 mg?kg -1 , respectively) was intravenously injected before heart ischemia. Plasma creatine kinase (CK), creatine kinase isoenzyme MB(CK MB), lactate dehydrogenase(LDH),? Hydroxybutyrate dehydrogenase (HBDH), grutamic oxalacetic transaminase(GOT), superoxide dismutase (SOD) activity and malondiadehyde (MDA) contents were measured. The pathologic changes of ischemia and reperfusion myocardium were observed on the transmission electron microscopy. RESULTS F 2 reduced the release of CK,CK MB LDH,HBDH,GOT from I/R rat hearts, increased the activity of SOD and decreased the MDA contents. In F 2 (1mg?kg -1 ) group, the serum CK MB LDH HBDH concentration was lowered significantly (vs I/R group P

Objective To explore the association between rs3758539G-803A and rs10882283 T-179G polymorphism of retinol binding protein 4 (RBP4) and rosiglitazone response in Chinese type 2 diabetes mellitus (T2DM) patients.Methods A total of 472 Chinese T2DM patients and 198 healthy subjects were enrolled to identify G-803A and T-179G genotypes using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP ).assay.Forty-two T2DM patients with different G-803A or T-179G genotypes were selected to undergo a 12-week rosiglitazone treatment (4 mg/d).Serum fasting plasma glucose (FPG),postprandial plasma glucose (PPG),fasting serum insulin (FINS),glycated hemoglobin (HbAlc),postprandial serum insulin ( PINS),triglyceride (TG),low-density lipoprotein-cholesterol ( LDL-c),and high-density lipoprotein-cholesterol (HDL-c) were determined before and after the rosiglitazone treatment.Results T2DM patients with RBP4 G-803A GG genotype showed lower TG and LDL-c concentrations compared with that in the GA +AA genotype subjects.T2DM patients with RBP4 T-179G TT genotype showed lower waist-to-hip ratio (WHR),FPG and FINS values compared with that in the TG + GG genotype individuals.Patients with GG genotype of RBP4 G-803A had an enhanced rosiglitazone efficacy on FPG and FINS compared with that in the GA + AA genotype group.Patients with RBP4 T179G TG + GG genotype showed an enhanced rosiglitazone efficacy on HbAlc level compared with that in the TT genotype group.Conclusion RBP4 G-803A and T-179G polymorphism might be associated with the development of T2DM and affect the therapeutic efficacy of rosignitazone in Chinese T2DM patients.

Objective To explore the potential value of tuberculosis protein chip for clinical diagnosis of tuberculosis.Methods The antibody level of tuberculosis protein ESAT-6,CFP10,16 KD,38 KD and LAM was determined in 4 093 patients,inclu-ding 441 tuberculosis and 3 652 non-tuberculosis cases by protein chip.Results The tuberculosis antibody was positive in 297 of the 441 tuberculosis cases and 647 of the 3 652 non-tuberculosis cases.Tuberculosis protein chip provided a sensitivity of 67.35% and specificity of 82.28% in the diagnosis of tuberculosis.Conclusions Tuberculosis protein chip test is a quick,easy and effective method for identifying potential tuberculosis patients with good specificity.