Objective To explore the effect of transforamen lumbar interbody fusion in treatment of lumbar intervertebral disk herniation with unilateral pedicle screw fixation. Methods Retrospectivly studied the clinical data of 36 patients with lumbar intervertebral disk herniation who were treated through transforamen lumbar interbody fusion with unilateral pedicle screw from January 2011 to October 2012. There were 22 male and 14 female patients, aged form 44 to 68 years old with mean age of 56. The lesion positions included 8 patients in L3/4, 17 patients in L4/5, and 11 patients in L5/S1. The data of operation time, intraoperative bleeding volume, and postoperative drainage volume were collected. Therapeutic effect were evaluated by visual analogue score (VAS), lumbar vertebral score of Japanese Orthopedic Association (JOA) score, and Oswestry dysfunction index (ODI). Results Operation time was 65-100 min with mean time of 85 min. Intraoperative bleeding volume was 100-250 ml with mean volume of 135 ml. Postoperative drainage volume was 100-200 ml with mean volume of 150 ml. Followed up for 12-36 months with mean time of 20 months. No loosening, breakage of screws or displacement of interbody fusion cages were found in the follow up period. The rate of anastomosis was 100%(36/36). The VAS was (7.9 ± 1.2) scores before operation and (1.1±0.3) scores at the end of follow up period, there was significant difference( P<0.05). The JOA score was (10.2±2.6) scores before operation and (23.2±4.3) scores at the end of follow up period, there was significant difference (P<0.05). The ODI was (43.3±6.2) scores before operation and (15.2±4.3) scores at the end of follow up period, there was significant difference ( P<0.05). Conclusion The effect of transforamen lumbar interbody fusion with unilateral pedicle screw fixation is proper for the patients who are suffering from lumbar intervertebral disk herniation, which has advantages of less invasion, less bleeding, better stability, better effect, quicker recovery and less complication.

BACKGROUND:Amniotic cells are mainly composed of amniotic epithelial cells and amniotic mesenchymal cells, which have multi-differentiation potential and can be transformed into neurons as wel as synthesize and release biological y active substances and neurotrophic factors. In preliminary studies, amniotic cells that are transplanted into the brain can significantly promote the regeneration of brain neurons. OBJECTIVE:To explore the role of amniotic cells in mouse brain cells after ischemia-reperfusion injury. METHODS:The model of cerebral ischemia-reperfusion injury was established in Babl/c mice using occlusion of bilateral common carotid arteries, and then brain cells were separated from mice. Amniotic cells were isolated from mouse placenta. Brain cells from Balb/C mice co-cultured with amniotic cells served as experimental group, and brain cells cultured with PBS as control group. RESULTS AND CONCLUSION:The viability of brain cells in the experimental group was significantly higher than that in the control group (P<0.05). There was no difference in necrotic rate of brain cells between the experimental and control groups after 24 and 72 hours co-culture (P>0.05);after 48 hours co-culture, however, the necrotic rate of brain cells was significantly lower in the experimental group than the control group (P<0.05). In cellcycle, the experiment group showed increased S phase cells;while, the control group exhibited increased G 1 phase cells and decreased S phase cells. G 2 phase cells had no changes in number in both two groups. Through the above results, amnion cells can be proved to protect and promote the regeneration of brain cells of Balb/C mice with ischemia-reperfusion injury, and inhibit cellnecrosis and apoptosis.

Objective To investigate the feasibility of sigrnoid coloplasty for patients after resection of middle or low rectal carcinoma, and to evaluate the defecation function after the operation. Methods Forty-three patients with middle or low rectal cancer who had been admitted to the cancer Hospital of the Chinese Academy of Medical Sciences from January 2007 to January 2008 received sigrnoid coloplasty after rectal carcinoma resection (treatment group), and another 43 patients who had been admitted during the same period received colonic J pouch reconstruction (control group). The feasibility and safety of the 2 surgical procedures and postoperative defecation function were assessed. All data were processed by t test, chi-square test or Fisher exact probability. Results The sigmoid coloplasty was successfully performed in all patients in treatment group, while the reconstruction of the J pouch failed in 4 patients in the control group. Three patients in each group underwent temporary transverse colostomy. The incidences of postoperative complications in treatment group and control group were 7% (3/43) and 9% (4/43), respectively, with no statistical difference between the 2 groups (X2 =0. 282, P > 0.05). The median frequency of defecation in treatment group was 2.0 ± 1.5 per 24 hours, which was significantly less than 2.5 ± 1.0 in control group (X2 = 1. 242, P > 0.05). The fecal incontinence scores in treatment group and control group were 1.7 ± 0. 7 and 1.6 ± 0.8, respectively, with no statistical difference between the 2 groups (t = 0. 285, P > 0. 05). Conclusion Sigmoid coloplasty has similar benefits to colonic J pouch reconstruction, while sigmoid eoloplasty is relatively feasible, effective and safe for low colorectal or coloanal anastomosis.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

Objective:To explore the effect of previous intestinal resection on anastomotic fistula within 30 days after surgery in Crohn′s disease.Methods:The clinical data from 92 Crohn′s disease patients who underwent intestinal resection and anastomosis at the Department of General Surgery in Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine from Jan 2016 to Sep 2019. Patients were divided into no previous intestinal resection group ( n=45) and previous intestinal resection group ( n=47). The relationship between previous intestinal resection and postoperative anastomotic leak in Crohn′s disease patients with intestinal resection and anastomosis was analyzed. Results:A total of 11 cases (12% leak rate) underwent postoperative anastomotic leak. There were 2 leaks in patients with no previous history of intestinal resection, while 9 leaks in patients with previous bowel resection (χ 2 =4.722, P=0.03). The OR of the postoperative anastomotic leak in Crohn′s disease patients with previous intestinal resection compared with no previous intestinal resection group was 5.092 (95% CI: 1.035-25.048). Patients with 1 previous resection (24 cases) had a leak rate of 13%, whereas patients with >1 previous resection episodes (23 cases) had a leak rate of 26%. The number of previous resection episodes correlated with an increasing risk for clinical anastomotic leak (correlation coefficien r=0.995). Conclusions:Previous intestinal resection is an independent risk factor for ensuing postoperative anastomotic leak in Crohn′s disease patients with intestinal resection and anastomosis.

Objective To investigate the natural penetrating radiation levels along the Qinghai-Tibet Railway, and to preliminarily evaluate the doses received by the railway employees and passengers. Methods Natural penetrating radiation was measured at 15 typical locations with different altitudes along the railway and in the carriages of a train from Lhasa to Xining using high-pressure ionization chamber RSS131, sodium iodide radiation dose rate meter MARS1561, and neutron ambient dose equivalent rate meter LB6411. Results The levels of terrestrial gamma radiation, cosmic ray ionization components, and neutron radiation were 21.5-246.6 nGy/h, 79.8-225.5 nGy/h, and 24.5-101 nSv/h, respectively. The effective dose of natural penetrating radiation received by passengers and crew on a train from Lhasa to Xining was 4.82 μSv. Conclusion Comparison with the empirical formula and verification of method reliability confirm the accuracy of the measurement. Our results provide a primary understanding of the radiation levels along the Qinghai-Tibet Railway and the radiation doses received by passengers, which can be used as a basis for the regulatory authorities.