Objective To explore the effects of minimally invasive technique in the treatment of lumbar spinal stenosis.Methods 80 lumbar spinal stenosis patients were divided into the observation group and control group,40 cases in each group,who were informed consent under the premise of the stochastic averaging grouping.The two groups were treated with microscopic invasive technology and traditional posterior bilateral fenestration decompression,and the therapeutic effect of two groups were compared.Results The average operation time of the observation group (36.2 ± 4.1) rain was obviously shorter than that of the control group (41.4 ± 5.7) min (t =2.719,P ＜ 0.05) ; the average amount of bleeding of the observation group (51.6 ± 7.3) ml was significantly lower than that of the control group(101 ± 11.7) ml(P ＜ 0.05) ; the two groups of patients before treatment JOA score had no significant difference after treatment,follow-up,JOA scores of the two groups increased significantly,the observation group increased significantly compared with the control group (P ＜ 0.05) ; the treatment group 19 cases of excellent,good in 17 cases,the excellent and good rate was 90％,control group 13 cases of excellent,good in 16 cases,the excellent and good rate was 72.5 ％,the treatment group was better than the control group (x2 =6.594,P ＜ 0.05) ; the observation group did not appear obvious postoperative complications occurred in 3 cases,the control group of nerve root injury,1 cases of intervertebral space infection,2 cases of incision leakage,the incidence of complications was 15％,observation complication rate was significantly lower than that of the control group (x2 =3.357,P ＜ 0.05).Conclusion The microscopic invasive technique for the treatment of lumbar spinal stenosis has a good curative effect,small trauma,high safety,which is conducive to improve the prognosis of patients,can gradually replace the traditional posterior bilateral fenestration decompression.

Objective To discuss the effects of triangle limited fixation by Russian external fixator for proximal and distal tibiofibular fractures. Methods From December 2005 to December 2007, 54 patients with tibiofibular fractures were managed with close reduction and triangle limited fixation by Russian external fixator. They were 48 males and 6 females, aged from 18 to 54 years (average, 34 years). By AO classification, there were two cases of type 41-C3 (one complicated with type 43-B2 and one with type 43-A3), 17 cases of 42-A, 13 cases of 42-B, 12 cases of 42-C, 5 cases of 43-B, and 5 cases of 43-C.Twenty-six cases were open injury (by Gustilo classification, type Ⅱ in 13, type ⅢA in 10, type ⅢC in 3),and 28 closed injury (by Tscherne classification, grade Ⅰ in 8 and grade Ⅱ in 20). Results Follow-ups of 50 patients revealed that the fractures healed from 2 to 6 months (average, 3 months). Swelling subsided in just one week in the 28 patients with close injury. Of the 26 patients with open injury, 24 obtained primary healing of wounds, one obtained wound healing 4 weeks after changes of dressing, and one suffered amputation. No malfunctions were found in this group. One case had nonunion which was healed after change to single-ann external fixation. Conclusion Triangle limited fixation by Russian external fixator can be applied in the treatment of complex tibiofibular fractures.

Chronic rhinosinusitis (CRS) is a common disease in otolaryngology, and with the development of the therapy technology, most of the cases have reached a cure. But there are still some intractable cases in clinic, signs and symptoms of chronic rhinosinusitis of which still persist after the standardized drugs and technically adequate endoscopic sinus surgery, and this part is clinically named refractory chronic rhinosinusitis (RCRS). In recent studies of the pathogenesis of RCRS, bacterial biofilm (BBF) is attracting more attention. The main emphasis of this review will be to highlight the biological characteristics of BBF, the relationship of BBF and CRS and treatment strategies of BBF positive CRS.
Biofilms ; Chronic Disease ; Humans ; Rhinitis ; etiology ; microbiology ; Sinusitis ; etiology ; microbiology

Objective To assess the effect of preoperative carbohydrate preconditioning on postoperative insulin resistance and inflammatory response in patients after gastroenteric tumor resection.Methods Sixty patients with elective gastroenteric tumor resection were divided into preoperative carbohydrate preconditioning group and control group by random digits table with 30 cases each.Preoperative carbohydrate preconditioning group was given oral containing 50 g glucose carbohydrate 300 ml 2 h before surgery,and control group was given traditional method,fasting 12 h before surgery and water deprivation 6 h before surgery.The blood samples were collected to measure the level of fasting blood glucose (FBG),fasting insulin (FINS),interleukin (IL)-6 and C-reactive protein (CRP),3 h before surgery and 1,3,7 d after surgery respectively.Homeostasis model assessment insulin resistance index (HOMA-IR) was computed.Results There were no statistical differences in FBG,FINS,IL-6,CRP and HOMA-IR 3 h before surgery between the 2 groups (P ＞ 0.05).The FBG,FINS,IL-6,C RP and HOMA-IR in the 2 groups at 1,3 d after surgery were significantly higher than those 3 h before surgery,but those except for FBG in control group were significantly higher than those in preoperative carbohydrate preconditioning group [1 d after surgery:(39.67 ± 10.37) mU/L vs.(25.78 ± 12.43) mU/L,(98.67 ± 12.42) μg/L vs.(65.36 ± 16.72)μg/L,(121.74 ±11.32) mg/L vs.(82.18 ±4.36) mg/L,19.07 ±5.49 vs.11.67 ±6.32;3 d after surgery:(24.34 ±6.78) mU/L vs.(16.23 ±7.56) mU/L,(116.43 ± 18.57) μg/L vs.(78.53 ± 10.38) μg/L,(151.30 ± 10.46) mg/L vs.(129.29 ± 10.24) mg/L,8.56 ±2.87 vs.5.12 ±2.11],there were statistical differences (P ＜0.05).There were no statistical differences in FINS and HOMA-IR in preoperative carbohydrate preconditioning group between 7 d after surgery and 3 h before surgery (P ＞ 0.05),but there was statistical difference in control group (P＜ 0.05).There were no statistical differences in FBG,IL-6 and CRP in the 2 groups between 7 d after surgery and 3 h before surgery (P ＞ 0.05).There was no aspiration during anesthetic stage.Conclusion Preoperative carbohydrate preconditioning may shorten the insulin resistance time after gastroenteric tumor resection,reduce the intensity of insulin resistance,and improve inflammatory response,thus contributing to the rehabilitation of patients.

Objective To explore a new peptide-based approach independent of HLA to generate antigen-specific CD+ CD8+T cells. Methods Peripheral blood mononuclear cells(PBMC) were stimula- ted for 6 h with IE-1 peptide pool. Then the activated IFN-γsecreting ceils were tested by immunomagnetic selection. And the selected cells were cultured with radio-inactivated PBMC in medium with 100 IU/ml IL-2 for 4 weeks. Results The generated T cell lines consisted of IE-1 specific CD4+ T (6.88%) and CD8+ T cells 92.99%, which demonstrated antigen-specific killing and cytokine secretion. Conclusion T ceils can be proliferated with this new procedure, and maintain its phenotype and antigen-specific function.

Objective To investigate the role of IL-11 and CTGF in bone metastasis of breast cancer.Methods A total of 180 pathologically confirmed breast cancer patients in Tianjin Medical University Cancer Institute and Hospital were enrolled,90 of which had bone metastasis.Twenty healthy people who took physical examination at the same period were adopted as controls,excluding those with endocrine or metabolic disease or other chronic diseases.Peripheral blood samples were collected and ELISA was employed to detect IL-11 and CTGF expression.Forty paraffin-embedded breast cancer tissue sections from those with bone metastasis and forty tissue sectioned from those without bone metastasis were detected for IL-11 and CTGF expression with immunohistochemisty.Results Serum IL-11 level was (242.9 ±56.3) μg/L in the group with bone metastasis and (85.9 ± 35.7) μg/L in the group without bone metastasis,with a significant difference (F =43.532,P ＜0.01).Serum level of CTGF was (15.6 ±7.4) μg/L in the group with bone metastasis and (15.0 ± 7.0) μg/L in the group without bone metastasis,with no significant difference (F =3.007,P ＞ 0.05).The rate of positive immunohistochemical staining for IL-11 in the group with bone metastasis (57.5％) was significantly higher than that in the group without bone metastasis (14.3％) (x2 ＝ 36.626,P ＜ 0.01).There was no significant difference in the positive rate of CTGF expression between the group with bone metastasis (17.5％) and the group without metastasis (14.3％) (x2 =0.370,P ＞ 0.05).Conclusions IL-11 expression is correlated with bone metastasis of breast cancer.Breast cancer patients with high IL-11 expression are more prone to develop bone metastasis.

Objective To construct a fusion protein to transfect some cell lines that were difficult to be transfected such as neoplastic cells, nerve cells, stem cells. Methods PCR was performed to amplified protein transductions domain(PTD),G4S and streptavidin (Strep).Enzymatic digestion and ligation were used to construct pAYZ-PTD-Strep plasmid. Fusion protein was induced to express by AP5 medium and was isolated by E-tag affinity chromatography. Fusion protein was identified by Western blot. eGFP was trasfected into U937 cells by pAYZ-PTD-Strep. FACS was performed to detect transfection percentage. Results Fusion protein PTD-G4S-Strep was expressed as soluble protein.The concentration of fusion protein was about 0.7 mg/L,and purity was over 90 ％. The protein could carry plasmid into a suspended cell line, U937 cells. The transfection-efficiency of protein was higher than monometer PTD.Conclusion The protein PAYZ-PTD-Strep could carry macromolecules into blood tumor cells,and its biological activity may be expected to develop into a highly efficient and reliable transfection method.

Objective: To analyze the status and trend of death from leukemia from 2006 to 2015 in Hangzhou,and to provide scientific basis for leukemia prevention and control. Methods: The data of deaths in Hangzhou from 2006 to 2015 were collected from Zhejiang chronic diseases surveillance system. The crude mortality rates,standardized mortality rates and cumulative rates of the age group 0-74 of leukemia were calculated. The annual percentage change（APC）was used to examine the changing trend of leukemia mortality. Results: The crude mortality rate of leukemia in Hangzhou was 4.38/100 000 and the standardized mortality rate was 3.79/100 000 from 2006 to 2015. The standardized mortality rates from 2006 to 2015 showed a decreasing trend and the APC was -2.27%（P<0.05）. The crude mortality rate of leukemia was 5.15/100 000 in males,which was higher than 3.62/100 000 in females（P<0.05）. The crude and standardized mortality rates were 2.00/100 000 and 0.45/100 000 in residents aged below 15 years,3.03/100 000 and 1.85/100 000 in residents aged 15-64 years,15.63/100 000 and 1.05/100 000 in residents aged 65 years or above. The standardized mortality rates of residents aged below 15 years and 15-64 years showed decreasing trends,the APCs were -9.24% and -3.82%,respectively（P<0.05）. The standardized mortality rates of residents aged 65 years or above showed an increasing trend,the APC was 3.77%（P<0.05）. Conclusion The standardized mortality rates of leukemia has presented a declining trend in Hangzhou from 2006 to 2015,with higher mortality in men and people aged 65 years or above.

[Summary] The study was to introduce quality of life measurement instruments for thyroid cancer,as well as the application of these scales.(1) Quality of life scales such as generic scale SF-36,tumor-specific scale EORTC QLQ-C30 were used in previous studies.(2) In these studies,the quality of life assessment was mainly used for measurement of quality of life in patients with thyroid cancer,comparative effectiveness research and specific psychological intervention evaluation,analysis of relevant factors affecting quality of life in patients with thyroid cancer.

Objective To discuss the clinical value of bile reinfusion via nasojejunal tube on liver function after biliary tract surgery. Methods Eighty patients with biliary tract surgery and bile outer drainage were divided into bile reinfusion group and control group by random digits table method with 40 cases each. The clinical data concerning the liver function and volume of biliary drainage were collected. Results The patients were well tolerated for bile reinfusion, and abdominal distension, nausea and vomiting occurred in some patients. The symptoms improved significantly after symptomatic treatment. The alanine aminotransferase (ALT) and total bilirubin (TBIL) levels at the fifth day after operation in bile reinfusion group were significantly reduced than those in control group:(31 ± 18) U/L vs. (48 ± 32) U/L and (51 ± 32)μmol/L vs. (76 ± 38)μmol/L, the aspartate aminotransferase (AST) and ALT levels at the seventh day after operation in bile reinfusion group were significantly reduced than those in control group: (32 ± 19) U/L vs. (43 ± 26) U/L and (20 ± 19) U/L vs. (31 ± 22) U/L, and there were statistical differences (P<0.05). The volume of biliary drainage in the bile reinfusion group was significantly increased compared with that in control group at the third and fourth day after operation:(485 ± 52) ml vs. (428 ± 96) ml and (509 ± 62) ml vs. (458 ± 59) ml, and there was statistical difference (P<0.01). Conclusions Bile reinfusion via the nasojejunal tube may facilitate the recovery of liver function after biliary tract surgery.