Pedicle screw fixation is widely used in spine surgery, which allows 3?dimensional fixation with a more rigid construct and permits a shorter fusion length. However, conventional pedicle screw fixation has some drawbacks, including signifi?cant muscle dissection for the exposure of bone marks. Although percutaneous pedicle screw technique can compensate for above defects, it requires an additional approach for decompression and bone graft insertion. Besides, the percutaneous pedicle screw technique depends on intraoperative multiplanar fluoroscopy, which results in high risk of radiation exposure of the surgeons and patients. Screw loosening is a well?known complication, especially in osteoporosis patients. Several methods can enhance screw stability, for example, modifying screw design and augmenting vertebral bodies with reinforcing materials that can improve the structural capacity of the deteriorated tissue, however, they also have some disadvantages. Although we can enhance bone?screw by modifying screw design, it is not useful in severe osteoporosis patients. At the same time, bone cement can increase pedicle screw axial pullout strength and fatigue resistance, however, it is associated with a number of inherent disadvantages such as its high exothermic polymerizing temperature, toxicity of the monomer, and risk of leakage to the spinal canal. Santoni et al. intro?duced cortical bone trajectory (CBT) for lumbar pedicle screw with a new screw design that is shorter and smaller in diameter which has been proposed to maximize the thread contact with this higher density bone surface. In addition, the CBT technique fol?lows a caudocephalad path sagittally and a laterally directed path in the transverse plane, engaging only cortical bone in the pedi?cle without the involvement of the vertebral body trabecular space. Finally, the screw insertion point of this technique locates around lateral pars, enabling less tissue dissection. Therefore, it can be an alternative approach to enhance screw fixation strength, and it may rescue failed pedicle screw and be used in minimally invasive spine surgery.

Cardiac surgery carried out on cardiopulmonary bypass(CPB) in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women.Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB.The CPB is associated with utero-placental hypoperfusion due to a number of factors,which may translate into low fetal cardiac output,hypoxia and even death.Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status,use of perioperative fetal monitoring,optimization of CPB,delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

Objective To investigate the influence of smoking,drinking cognition and behavior among the officers and soldiers in South China War Zone after health management,and to explore the establishrent of appropriate health management model for the army.Methods Harmfulness cognition,rate,quantity,types of drinking and smoking were investigated and analyzed before and after health management among 1 102 officers and soldiers in South China War Zone by providing a set of health education,psychological counseling service,disease and lifestyle intervention of health management as a whole.Results The harmfulness cognition rate of smoking and drinking raised from 95.6％ and 94.1％ to 98.7％ and 97.8％,the smoking and drinking rate dropped from 64.7％ and 72.6％ to 37.2％ and 61.4％ after health management.The x2 values were 18,18.9,153,20.8,and had significant difference (P＜0.001).The rate of occasional smoking,a small amount of smoking,often smoking dropped from 28.3％,25.8％,45.9％ to 18.5％,12.2％,31.5％ as well as the rate of occasional drinking,a small amount of drinking,often drinking has dropped from 56.6％,32.3％,11.1％ to 49.8％,23.4％,4.1％.The x2 values were 26.8,62.1,31,9.61,8.06,19.4,and had significant difference (all P＜0.01).Conclusion The health management improves the harmfulness cognition of smoking and drinking,and decreases the rate and quantity of smoking and driking.It has a positive effect on improving the heahh literacy and developing health way of life in officers and soldiers.

OBJECTIVE: To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer. METHODS: In this prospective, single-blinded, controlled clinical trial, thirty-one patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation. RESULTS: Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation.IL-6, CRP and TNF-alpha tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation. CONCLUSION: Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.

Objective To prove that valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair for patients with acute type A aortic dissection.Methods Clinical data of 98 consecutive AAAD patients undergoing the valve sparing aortic root reconstruction were analyzed.The postoperative follow-up and the clinical effect of the procedure were retrospectively analyzed.Results Pre-operative grade of aortic insufficiency was(2.3 ± 0.5), CPB-time was (217.8 ± 43.1)min, aortic cross clamp time was(142.7 ± 37.4)min and stay on ICU (11.1 ± 5.7) days, while hospitalisation was(14.3 ± 3.2) days.8 patients(8.2％) died peri-operatively.None of the early deaths were valve-related.Rethoracotomy rate was 3.1％.All patients followed up(19.3 ± 7.6) (6-68) months.Survival at 1 year was 90.8％.Freedom from valvular reoperation was 97.9％ at 3 years.At last investigation, mean grade of aortic insufficiency for AADA was 0.5 ± 0.3 (0-3).Conclusion Regardless of the underlying indication, the aortic valve preserving reimplantation technique can be performed with favourable functional results.

Objective To investigate the effects ofdocosahexenoic acid (DHA) on large conductance Ca2+-activated K+ (BK) channels in normal retinal artery smooth muscle cells (RASMCs).Methods Cultured human RASMCs (6 th-8 th generations) were used to patch clamp experiment.The open probabihties (NP0) in BK channels with different concentrations (0.0,1.0,3.0,5.0,7.5,10.0 μmol/L) of DHA were recorded by patch clamp technique in single channel configuration.RASMCs were intervened by different concentrations (0.0,1.0,5.0 μmol/L) of DHA as control group,low and high doses of DHA groups,respectively.The protein expressions of β subunit of BK channels in RASMCs from three groups were measured by Western blot.Results The NP0 of BK channels were 0.044 4±0.001 2,0.081 2±0.004 2,0.209 0±0.006 1,0.310 5±0.005 3,0.465 0±0.007 8 and 0.497 7±0.014 5 with perfusate of 0.0,1.0,3.0,5.0,7.5,10.0 μtmol/L DHA.DHA activated BK channels in a dose-dependent manner (F=2.621,P＜0.05).There was no significant difference in the protein expression of control group,low and high doses of DHA groups (F=1 1.657,P＞0.05).Conclusion DHA can directly activate BK channels,no increasing in subunit expression of BK channels.

Objective:To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy .Methods:After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients , we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate , blood pressure , pulmonary arterial pressure , arterial partial pressure of oxygen and hemachrome before and after thrombolysis , as well as the thrombolysis effect time the two groups took.Results: The heart rate, blood pressure, pulmonary arterial pressure , arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation ( P<0 .05 );the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation ( P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation ( P<0.05 ); the hemachrome of both patient groups did not significantly drop after operation ( P>0 .05 );the thrombolysis effect time by adop-ting r-tPA was remarkably shorter than that caused in thrombolysis by adopting urokinase ( P<0 .05 ) . Conclusion: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism .However , r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.

Objective:To investigate the relationship of hypertension with osteoporosis(OP)and bone mineral density(BMD) in elderly type 2 diabetic women.Methods: A total of 179 elderly type 2 diabetic women were categorized into hypertension group(n=124)and non-hypertension group(n=55).Lumbar and hip BMD were measured by dual-energy X-ray absorptiometry.Prevalences of osteoporosis were compared between the two groups using Chi-square test,and BMD was compared using covariance analysis.The correlation between the osteoporosis and risk factors was analyzed using binary logistic regression method.Results: The prevalences of osteoporosis(total OP,lumber OP and hip OP) in non-hypertension group were higher than that of the hypertension group(Pt=0.037,Pl=0.042 and Ph=0.051,respectively).Lumbar and hip BMD in the hypertension group was higher than that in the non-hypertension group,and there were significant differences in L3 and L4 BMDs between the two groups(P3=0.040,P4=0.021);however,the difference disappeared after adjustment for body mass index(BMD).After adjustment for C peptide,the P value also increased,but not as obvious as after adjustment for BMI.Binary logistic regression analysis showed that OP was associated with age,BMI and osteocalcin,but not with hypertension.Conclusion: OP is associated with the age,BMI,and osteocalcin,but not with hypertension in elderly type 2 diabetic women.

Animals ; Antihypertensive Agents ; pharmacology ; Blood Pressure ; drug effects ; Cold Temperature ; Hypertension ; etiology ; physiopathology ; Hypolipidemic Agents ; pharmacology ; Isoflavones ; pharmacology ; Kidney ; pathology ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Male ; Mice ; Mice, Inbred ICR