Objective To compare the fusion effect between lumbar posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) in elderly patients with lumbar spinal stenosis.Methods Data of 313 patients undergoing PLF or PLIF for treatment lumbar degenerative disease in Department of Orthopedics,Beijing Hospital of China Ministry of Health during January 1996 to December 2011 were retrospectively analyzed.Patients were divided into PLF group (n=116 cases) and PLIF group (n=197 cases).Data of fusion rate,operative time,operative blood-loss and complications were analyzed statistically.Results The fusion rate was 84.5％ in PLF group and 98％ in PLIF group.The average operative time was 247.8 min (120-480 min) and 240.6 min (90-600 min) in PLF and PLIF groups respectively.The blood-loss was 1142.9 ml (200 4500 ml) and 927.0 ml (200-2800 ml) in PLF and PLIF groups respectively.Postoperative complications were found in 38 cases in PLF group and in 36 cases in PLIF group.There were significant differences in fusion rate,operative time,operative blood loss,complications between the two groups (all P＜0.05).Conclusions PLIF has better effects on fusion rate and fusion grade than PLF.

Objective:To compare the results of lymph node dissection boundaries along the right or left sides of SMA in laparoscopic radical resection for right colon cancer.Methods:One hundred and two patients with advanced right colon cancer were selected for retrospective analysis, the patients were divided into study group (48 cases) and control group (54 cases) according to the extent of lymph node resection. The medial boundary of lymph node dissection in the study group was on the left side of SMA, and the control group was on the right side of SMA. The operation duration, hospital stays, CRP(postoperative day 1), the number of dissected lymph nodes and the complications were compared.Results:The operation duration of the study group was longer than that of the control group[(169±24)min vs.(138±28)min, t=4.827, P<0.05], but there was no statistically significant difference in hospital stays[(10.5±1.7)d vs.(9.7±2.0)d, t=1.172, P>0.05], CRP(postoperative day 1) [(110±44)mg/L vs.(100±39)mg/L, t=1.287, P>0.05], incidence of postoperative complication(12 cases vs. 9 cases, P>0.05) between the two groups.The number of lymph nodes removed in the study group was more than that in the control group[(23.8±8.2) vs.(19.7±6.8), t=2.191, P<0.05], though the number of positive lymph nodes removed in the two groups was not significantly different[(2.2±4.9) vs.(1.4±2.8), t=0.863, P>0.05]. Conclusions:Laparoscopic radical resection for right colon cancer along the left sides of SMA removed more lymph nodes without significant increase of the surgical complications.

Objective: To investigate the difference of clinical characteristics of recurrent spontaneous abortion (RSA) in patients with losses after spontaneous gestation and after in vitro fertilization and embryo transfer ( IVFET) ． Methods : 237 patients diagnosed with RSA were divided into spontaneous gestation group ( n = 185) and IVF group (n = 52) according to their previous modes of fertilization．The clinical characteristics of the two groups were analyzed. Results: Compared with the spontaneous gestation group，the age of the first pregnancy and the age at the time of RSA in the IVF group were statistically greater than those in the natural pregnancy group ( P < 0. 05 ) ．The number of biochemical pregnancies in IVF group was statistically higher than that in spontaneous gestation group，and the number of spontaneous abortions in IVF group was statistically lower than that in spontaneous gestation group (P＜0. 001) ．The proportion of patients with irregular menstruation in IVF group was statistically higher than that in spontaneous gestation group ( P ＜ 0. 05 ) ． The serum activated partial prothrombin time (APTT) ，R , K，high density lipoprotein cholesterol (HDL-C) ，thyrotropin (TSH) and homocysteine ( HCY) in IVF group were statistically lower than those in spontaneous gestation group，and the Angel，Ma，low density lipoprotein cholesterol (LDL-C) and body mass index (BMI) in IVF group were statistically higher than those in spontaneous gestation group (P＜0. 05) ．In the comparison of etiological composition between the two groups，the proportion of anatomical factors in IVF group was statistically higher than that in spontaneous gestation group (P < 0. 05) ． Conclusion The abortion risk factors in RSA patients after IVF-ET is more serious than that in RSA patients after natural pregnancy．It is suggested to further improve and implement the pre-pregnancy examination and education of infertile patients during IVF-ET treatment，so as to reduce the risk of RSA and obtain a better pregnancy outcome.

Objective : To analyze the metabolism of blood glucose，blood lipid and insulin in patients with recur- rent pregnancy loss (RPL) ，and to compare the predictive efficacy of triglyceride glycemic index (TyG) ，triglycer- ide glycemic body mass index (TyG-BMI) and homeostatic model assessment of insulin resistance( HOMA-IR) for RPL． Methods : A total of 573 patients with RPL were selected as the RPL group，and 652 women who received as- sisted reproductive technology for male infertility were selected as the control group．The general data of the two groups were retrospectively analyzed．The levels of body mass index(BMI) ，fasting blood glucose (FPG) ，fasting triglyceride (FTG) ，fasting insulin ( FINS) ，TyG index，TyG-BMI index and HOMA-IR were compared between the two groups．Spearman correlation analysis was used to verify the correlation between TyG index，TyG-BMI in- dex and HOMA-IR. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of TyG index，TyG-BMI index and HOMA-IR for RPL occurrence，and the optimal predictive cut-off point was calculated. Results : The BMI，FPG，FTG，TyG index，TyG-BMI index and HOMA-IR in the RPL group were significantly higher than those in the control group (P＜0. 05) ．TyG index and TyG-BMI index were positively correlated with HOMA-IR , and the correlation coefficients were 0. 442 and 0. 505，respectively (P＜0. 001) . ROC curve a- nalysis showed that the area under the curve of TyG-BMI index predicting RPL was 0. 579 (95% CI : 0. 551 - 0. 607，P＜0. 001) ，which was greater than that of TyG index of 0. 557 (95% CI : 0. 529－0. 585，P＜0. 001) and HOMA-IR of 0. 535 (95% CI : 0. 507 －0. 563，P ＜0. 05) ，among which the difference between TyG-BMI index and HOMA-IR index area under the curve was statistically significant (P ＜0. 05 ) ．The optimal cut-off points of TyG-BMI index ，TyG index and HOMA-IR for predicting RPL were 172. 3 ( sensitivity 75. 7% ，specificity 37. 06% ) ，8. 32 ( sensitivity 59. 44% ， specificity 51. 61% ) and 3. 58 ( sensitivity 25. 87% ， specificity 81. 62% ) ，respectively． Conclusion The incidence of overweight，abnormal blood glucose，lipid and insulin me- tabolism in RPL patients is higher than that in normal women．TyG index and TyG-BMI index can be used as indi- cators of insulin metabolic status in RPL population besides HOMA-IR , and TyG-BMI index has a higher efficacy in predicting the occurrence of RPL compared to HOMA-IR.