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BACKGROUND:Computer-assisted navigation technique has been widely applied in spinal surgery, but there is stil lack of systematic reviews on this technique in lumbar pedicle screw fixation.
OBJECTIVE:To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation.
METHODS:Databases such as PubMed, Embase and China journal ful-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as wel , and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared.
RESULTS AND CONCLUSION:Final y 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95%confidence interval (CI):(0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI:(-246.26,-98.53), P<0.000 01] had statistical y significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI:(-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI:(0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is stil needed to make clear whether this technique can improve final outcome in post-operative patients.

This study is to prepare the pantoprazole sodium enteric-coated tablet which is compacted by pellets. The enteric-coated pantoprazole sodium pellets were prepared by fluid bed coating technology. The pantoprazole sodium enteric-coated tablets were prepared by direct compression of the enteric-coated pellets and suitable excipients. In vitro dissolution method and scanning electron microscope method were used for the observation of the drug release behavior before and after compression of the pellets. The optimized formulation is: the coating level is 55%, the plasticizer content is 20%, the ratio of Eudragit L30D-55/NE30D is 8 : 2, enteric-coated pellets/excipients (MCC/PPVP/PEG 6000 = 2 : 1 : 1) is 5 : 5, the enteric-coated tablets release in artificial gastric fluid in 2 h is less than 10%, while in artificial intestinal fluid in 1 h is more than 85%. The release behavior of pantoprazole sodium enteric-coated pellets-type tablet is quite well. And it may be used in industrial production.

Objective To explore the functional expression and temporality of MDR1 gene in bone marrow of rabbits after autologous bone marrow transplantation with MDR1 transferred bone marrow mononuclear cells. Methods The supernatant of the amphotropic virus producer cell line PA317-HaMDR1/A was collected and concentrated to cocultivate with the bone marrow mononuclear cells of the rabbits. After large dose of chemotherapy with cyclophosphamide,the transferred cells were autotransplanted into the bone marrow. The integration,transfection rate and physiological function of MDR1 gene were tested by PCR,SP immunohistochemical method and daunorubicin (DNR) extrusion test respectively. Results After autologous bone marrow transplantation had been executed for 1-4 months,the integration of MDR1 gene in genome of bone marrow mononuclear cells was detected by PCR,and the expression rates of P-gp in cells tested by SP immunohistochemical method were 9.5%,8.5%,6.0% and 3.5% respectively. The physiological function of MDR1 gene in bone marrow cells was proved by DNR extrusion test. Conclusion After the autotransplantation with bone marrow mononuclear cells transferred by MDR1 gene,the MDR1 gene can implant into the bone marrow of rabbits and has expressed functionally for 4 months,which has provided a basis for further research on chemoprotection experiment of the MDR1 gene transferred into the bone marrow cells.

Objective To analyze 206 cases of pregnant women with multiple organ dysfunction syndrome(MODS)due to different primary diseases and the prognosis.Method A retrospective study was conducted of 206 cases of pregnant women with MODS who were treated during January 2000 to December 2006 in the Third Affiliated Hospital of Guangzhou Medical College,regarding their primary disease and prognosis.Results Fourty-four cases among the 206 pregnant women with MODS died.The main primary causes were postpartum hemorrhage in 63 cases(30.6%),severe preeclampsia or eclampsia 60 cases (29.1%),pregnancy with hepatitis C in 23 case(11.2%),pregnancy with heart disease in 11 cases (5.3%),12 cases of ectopic pregnancy(5.8%).The mortality was mainly because of pregnancy complicated with heart disease(63.6%),ectopic pregnancy(41.7%),pregnancy with hepatitis (22.7%),of postpartum hemorrhage(17.5%)and severe preeclampsia-eclampsia(11.7%).The difference was statistically significant(P

Objective To evaluate the clinical effects of surgical treatment for diabetic retinopathy (DR) with diffuse diabetic macular edema (DDME) and massive subretinal hard exudates (MSHE) with vitrectomy, endolaser photocoagulation to the retina under perfluorocarbon liquid and long acting gas tamponade. Methods Fifteen eyes of twelve patients with DR complicated with DDME and MSHE admitted from October 2001 to December 2003 were enrolled for study, in whom 9 eyes were in 7 males and 6 eyes in 5 females. The patients were aged from 36~65 years (mean 53.4). The best corrected visual acuity (BCVA), color fundus photography and fundus fluorescein angiography were recorded, and optic coherence tomography was performed preoperatively. Pars plana vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade were the therapeutic modalities used to treat the diseased eyes. Results Preoperative BCVA was finger counting to 0.05 in all 15 eyes. Improved vision was observed in eyes during 4~25 months of follow up period (mean 10.26 months), 0.03~0.04 in 2 eyes(13.3%), BCVA ≥0.09 in 13 eyes(86.7%), and 1 eye(6.7%)showed an improved vision from 0.04 to 1.0. Significant decrease in macular edema and retinal thickness were observed, and marlsed to complete absorption of intra-retinal and pre-retinal hemorrhage as well as MSHE was also seen. Conclusions Vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade may offer satisfactory effects in the treatment for DDME complicated with MSHE.

Objective To explore the clinical value of real-time contrast-enhanced ultrasonography and ultrasonography in the diagnosis and staging of cervical cancer.Methods 80 cervical cancer patients were selected as the research subjects,they were randomly divided into two groups.40 patients in the observation group received real time contrast-enhanced ultrasound,40 cases of the control group received conventional ultrasonography.The detection rate,diagnosis of cervical cancer,cervical cancer tissue and normal tissue parameters were compared between the two groups.Results 35 patients were detected in the observation group,the detection rate was 87.5%,23 patients were detected in the control group,the detection rate was 57.5%,the detection rate of the observation group was significantly higher than the control group (x2=9.028,P=0.002).In the observation group,7 patients in stage Ⅰ(17.5%),1 case in the control group (2.5%),there was significant difference between the two groups (x2=5.000,P=0.025),the differences in phase Ⅱ,Ⅲ and Ⅳ were not statistically significant(P>0.05).In observation group,the peak intensity of cervical cancer was (65.43±10.55)%,and the peak time was (22.09±2.82)min,the peak intensity of normal tissue was (58.21±14.12)%,peak time was (28.27±3.01)min,the peak intensity of cervical cancer was higher than normal tissue,the peak time was shorter than normal tissues,the differences were statistically significant(t=2.590,9.476,all P<0.05).The differences of the area under the curve and the average transit time between normal tissue and cervical cancer tissue were not statistically significant(P>0.05).Conclusion Compared with conventional ultrasonography,the contrast-enhanced ultrasonography can clearly show the range of tumor,quantitative analysis of time intensity curve parameters,can better reflect the characteristics of cervical cancer lesions,can improve the diagnostic rate and clear clinical stage.

Objective To observe the differential gene expression in human nasopharyngeal carcinoma (NPC) cell line with different radiosensitivity by cDNA microarray analysis. Methods A radioresistant cell line, CNE-2R, was established from a human nasopharyngeal carcinoma cells line CNE-2 by repeated X-ray irradiation. The differential gene expression of CNE-2 and CNE-2R was screened with cDNA microarray by BioStarH-141s profile gene chip. Results There were expressed 308 genes to be screened out between CNE-2R cell line with different radiosensitivity and its parental CNE-2 cell line, while 176 up-regulated genes in CNE-2R cells and 132 down-regulated genes were found. In them, there were 40 up-regulated ones and 36 down-regulated ones whose ratios were higher than 6.0 or lower than 0.1. The different genes included DNA damage- and repair-related genes; cell cycle-related and cytoskeleton-related proteins; and apoptosis-related genes. Conclusion The radioresistant CNE-2R cells were isolated from the CNE-2 cell line by repeated X-ray irradiation. The stable radioresistance is the result of co-effect by polygene and multiple factors, which provide several gene targets to sensitize the radioresistant cells for improving the radiocurability of NPC.

Objective To access the ability of MRI for detecting the radial meniscal tears.Methods Arthroscopy of the knee was performed by a single orthopedic surgeon on 1085 patients. On the basis of the results of arthroscopy, 107(9.9%) knees had radial tears of menisci. Through interval sampling of the patients with meniscal tears but not radial tears, 100 patients were selected as a controlled group. All MR images were analyzed by two radiologists independently. Four radiological signs were used to detect radial tears: cleft and marching cleft sign, detached sign, ghost sign, and small meniscal sign. All the features of MRI were compared with the results of the arthroscopy. Results (1) The most frequent location of radial tears was the midbody of lateral meniscus (71/107, 66. 4%)followed by the boundary of anterior horn and midbody of the lateral meniscus (25/107, 23.4%). (2) One hundred and two of 107 patients were identified as radial tears on MRI. However, 11 of 100 patients with non-radial tears were misdiagnosed as radial tears by MRI. The sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 95.3% (102/107),89.0% (89/100),90.3% (102/113), and 94.7% (89/94),respectively. (3) The cleft sign (59/102, 57.8%) and detached sign (43/102, 42.2%) were the most frequent and important MRI signs. Conclusion The accuracy of MRI to identify the radial meniseal tears'is very high and MRI is the best imaging modality for patients suspected of radial meniscal tears.

Objective To investigate clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma (MPCC). Methods A retrospective analysis was made on 37 patients with MPCC admitted from 1974 to 1998. ResultsThe incidence of MPCC was 2 74%(37/1 348) with 15 cases being synchronous carcinoma (SC) and 22 cases diagnosed as metachronous carcinomas (MC). Most tumors were located in right colon and rectum. Twelve out of twenty-two (55%) of MC were diagnosed within 3 years from the primary operation and 41% (9/22) of MC occurred after 8 years. JP2Radical resections were performed in all patients except for 1 case. The 5 year survival rate of SC was 5/9 and that of MC after the first cancer or second cancer were 15/21 and 7/18, respectively. Conclusions The results indicated the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and active radical resection can increase survival rate of MPCC.