Objective To study the expression of carbonic anhydrase 9(CA9) in clear cell renal carcinoma(ccRCC), and the relationship between the expression and recurrence .Methods Paraffin-embedded tissues from 53 ccRCC cases were collected during the past 3 years,and immunohistochemistry was used to detect the expression of CA 9.Fifty-three cases were followed up to evaluate the disease-free survival ( DFS) and recurrence .Association of CA9 expression with recurrence was then analyzed .Results Localized RCC recurred in eleven cases , the median DFS was 10 months, the integral optical density ( IOD) of the recurrent cases was 230 879 .84 ±64 878 .72 while the IOD of the thirteen nonrecurrent cases was much higher,444 993.31 ±146 946.27(P<0.01).Conclusion There might be a positive correlation between the low expression of CA9 and the recurrence of ccRCC .CA9 may help predict the ccRCC patients ’ prognosis.

Background The simplex congenital blepharoptosis is the common blepharon motor dysfunction disease.Some researches have shown that congenital blepharoptosis is related to the hypoplasia of levator.Objective This study was to investigate the thickness and pathological features of levator palpebrae superioris aponeurosis in congenital blepharoptosis patients.Methods A prospective cohort study was carried out in Anyang Eye Hospital from March 2012 to April 2014.Eighty-five eyes of 56 patients with congenital blepharoptosis were divided into mild (15 eyes), moderate (25 eyes) and severe blepharoptosis (19 eyes) groups, and the fellow eyes of monocular blepharoptosis was used as fellow eye group (26 eyes).Twenty-six eyes of 13 normal subjects were recruited for the normal control group.The thickness of levator aponeurosis was measured by ultrasound biomicroscope (UBM) , and the shifting range of levator aponeurosis was detected by using measuring scale.Levator aponeurosis specimens were collected during the levator palpebrae superioris shortening surgery for the pathological examination.The study was approved by the medical ethics committee of Anyang Eye Hospital, and the patients or their guardian signed the informed consent.Results The thickness of levator aponeurosis was (0.331±0.018), (0.373±0.026), (0.539± 0.023) , (0.557 ± 0.024) and (0.547 ± 0.028) mm in the severe blepharoptosis group, moderate blepharoptosis group,mild blepharoptosis group, normal control group and fellow eye group, respectively, showing a significant difference among them (F =1.681, P =0.043).The thickness values of levator aponeurosis were considerably lower in the severe blepharoptosis group and moderate blepharoptosis group than those in the mild blepharoptosis group,fellow eye group and normal control group (all at P＜0.05) , and the thickness value of levator aponeurosis was significantly reduced in the severe blepharoptosis group compared with the moderate blepharoptosis group (P＜0.05).Pathological examination showed arranging disorder of muscle fibers,hyaline-like degeneration, connective tissue hyperplasia and interruption of endomysium.The number of eyes with severe hyaline-like degeneration and connective tissue hyperplasia was significantly increased in the severe blepharoptosis group than that in the moderate blepharoptosis group or the mild blepharoptosis group, as well as in the moderate blepharoptosis group than that in the mild blepharoptosis group(all at P＜0.01).The adipose cells in muscle in the mild blepharoptosis group, moderate blepharoptosis group and severe blepharoptosis group were (12.35±4.62), (17.58±7.46) and (26.19±10.81)/field,and adipose cells in the severe blepharoptosis group were significantly more than those in the mild and moderate blepharoptosis groups (t =5.60, P =0.00;t =2.71, P =0.01).A significant increase in the adipose cells also was seen in the moderate blepharoptosis group compared with the mild blepharoptosis group (t =2.44, P =0.02).Conclusions UBM can offer accurate thickness data of levator aponeurosis.The combination of thickness data and shifting range measurement of levator aponeurosis is helpful for the evaluation of muscle strength.The development of levator aponeurosis appears to be abnormal in congenital blepharoptosis patients.The histopathological change parallels to the severity of the disease.

Objective. To observe the clinical outcomes of using a new instrumentation SOCON system in the treatment of degenerative spondylolisthesis.Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system.Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post- operative satisfactory rate was 90.5%. Pain relief was 90.5%. Neither infection nor neurologic complication occurred in this series.Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.

Background:Resistance of Helicobacter pylori(Hp)to antibiotics is the primary reason for failure of Hp eradication therapies. It has been reported that there are regional differences in the resistance rate of Hp to commonly used antibiotics. Monitoring the regional Hp resistance status is helpful for improving the eradication rate in local area. Aims:To investigate the resistant spectrum of clinical Hp strains to commonly used antibiotics in Jiaxing Area,Zhejiang Province. Methods:A total of 17 402 patients who underwent gastroscopy from Jan. 2009 to Dec. 2013 at Jiaxing First Hospital were recruited for Hp culturing by using gastric antral biopsies. Then a drug sensitive test was performed for the Hp strains obtained from the culturing. Sensitivity of these Hp strains to metronidazole,amoxicillin,gentamicin,furazolidone,clarithromycin and levofloxacin was determined. Results:Among the 17 402 cases of gastric antral biopsies,5 898(33. 9% )were positive for Hp culturing. Drug sensitive test revealed that the resistance rate of metronidazole was extremely high in all year and age groups;the resistance rates of clarithromycin and levofloxacin were increasing by years;and the resistance rates of furazolidone,amoxicillin and gentamicin were considerably low in all year and age groups. When two antibiotics were combined,amoxicillin and gentamicin accounted for the lowest resistance rate,and the next were amoxicillin and furazolidone,and gentamicin and furazolidone,respectively. Conclusions:The clinical Hp strains isolated from all age groups in Jiaxing Area,Zhejiang Province are highly resistant to metronidazole,therefore it is not recommended to be used in first line eradication regimen. Amoxicillin combined with gentamicin/ furazolidone is an ideal antibiotic combination for patients with Hp infection in all age groups;and combination of gentamicin and furazolidone is recommended to patients who are allergic to penicillin.

AIM: To explore the expression of nuclear factor-?B(NF-?B) in asthmatic guinea pigs, and the effect of erigeron breviscapus, a protein kinase C(PKC) inhibitor, on the expression of nuclear factor-?B(NF-?B). METHODS: 48 guinea pigs were randomly divided into 6 groups ( n= 8). Airway resistance and eosinophilic inflammation of airway wall were examined, the expression of NF-?B in the lung tissue was detected by immunohistochemical staining. RESULTS: The expression of NF-?B was mainly found in airway epithelium, all the asthmatic animals showed significantly higher optical densities than that of the normal control group( P

BACKGROUND: Low back pain and low limb disability are classical symptoms of patients with degenerative lumbar spondylolisthesis who are often treated with operative internal fixation.OBJECTIVE: To observe the improvement of low-back pain and low-limbs disability of patients with degenerative lumbar spondylolisthesis following the treatment with general spine system(GSS).DESIGN: Self control clinical study with patients as subjects.SETTING: Department of Orthopaedics, Peking Union Medical College Hospital.PARTICIPANTS: Sixteen patients with degenerative lumbar spondylolisthesis combined with lumbar stenosis, including 10 males and 6 females with the average age of 58.5 years(ranged from 42 to 72 years) received treatment in our hospital between September 2001 and December 2001. Patients with low back pain were found in 16 cases and low-limb claudication in 15cases; preoperative spondylolisthesis of grade I was observed in 10 cases and grade Ⅱ in 6 cases.METHODS: After receiving lumbar canal decompression by spinal process and GSS for restoring spondylolisthetic vertebra, as well as internalfixation and lumbar fusion operation, patients were followed up at postoperative week 2 and month 1,3,6,12,18,24 for assessing the low-back pain and low-limb disability and meanwhile preoperative spondylolisthesis and postoperative restroration were also assessed with X-ray.RESULTS: Totally 16 patients were followed up for an average of21.2appeared in 15 out of 16 patients, and intermittent claudication resumed to time of follow-up revealed that all spondylolisthetic vertebra were restored with restoring rate of 100% (16/16).CONCLUSION: GSS was proved of satisfactory therapeutic effect in patients with spondylolisthesis by obviously improving their low-back pain and intermittent claudication.

OBJECTIVETo introduce a new spinal internal fixation system, Texas Scottish Rite Hospital (TSRH), and to investigate its early clinical outcomes.

METHODSThe preliminary clinical outcomes of 15 patients with thoracolumbar or lumbar scoliosis treated by anterior spinal fusion with TSRH instrumentation were studied retrospectively. Fourteen patients were diagnosed as idiopathic scoliosis and 1 as neuromuscular scoliosis.

RESULTSPreoperatively, the Cobb's angle on the coronal plane was 55.8 degrees (range 35 degrees to approximately 78 degrees), and 14 degrees postoperatively, with an average correction of 74.8%. The average unfused thoracical curve was 35.9 degrees preoperatively (range 26 degrees to approximately 51 degrees) and 21.8 degrees (10 degrees to approximately 42 degrees) postoperatively, with 40% correction. The sagittal curve of lumbar was kept physiologically, preoperative 27.9 degrees and postoperative 25.7 degrees respectively. The trunk shift was 13.4 mm (5 to approximately 28 mm) preoperatively and 3.5 mm (0 to approximately 7 mm) postoperatively. The averaged apic vertebra derivation was 47.8 mm (21 to approximately 69 mm) before operation and 10.8 mm (3 to approximately 20 mm) after operation. The distance of C7 to center sacrum vertical line (CSVL) was 19.5 mm (16 to approximately 42) preoperatively and 11.3 mm (0 to approximately 32 mm) postoperatively. The apical vertebra rotation was 3 degree in 15 patients preoperatively, and were improved to normal in 10 patients, 1 degree in 4 patients, and 2 degree in 1 patients postoperatively. None had neurological injury and infection. Only 1 patient complained a cool feeling in the low extremity of concave side, and the symptom vanished at 3-month followed up.

CONCLUSIONIf used appropriately, TSRH anterior spinal system is a good teatment for low thoracic or thoracic lumbar scoliosis.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; diagnostic imaging ; surgery ; Male ; Radiography ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Treatment Outcome

Objective. To evaluate the results of TSRH instrumentation in the correction of coronal, sagittal and rotational deformity of scoliosis. Methods. From January 1998 to December 1999, thirty-two consecutive patients (6 males, 26 females) with scoliosis underwent anterior or posterior spinal instrumentation and fusion using TSRH instrumentation. Of these cases, 21 were idiopathic scoliosis and 11 were congenital scoliosis. The average age at surgery was 16.4 years (range, 11～ 45 years). The mean Cobb angle at surgery was 71 .2 (range, 44 ～ 125 ) in the coronal plane, and 49.2 ( range, 16 ～ 67 ) in the sagittal plane. Rotational deformity (Nash -Moe) ranged from I to III degree. Preoperative apical translation averaged 4.8 cm (range, 3～ 9 cm). Results. The average follow-up duration was 13.3 months (range, 10 ～ 24 months).At the final follow-up, the mean Cobb angle in the coronal plane was 26. 6 (range, 10 ～ 73 ),with a 63.8％ of improvement. Sagittal alignment was well maintained with a mean Cobb angle of 28 ( range, 10 ～ 45 ). The average correction of rotation of the apical vertebra was I degree. The average apical translation was 1.6 cm (range, 0.5～ 5.0 cm) representing a correction rate of 66,7％ . Complication was noted in two cases with an incidence of 3.1 ％ , one case had superficial infection and the other one had lower hook dislocation.There was no neurologic deficit and pseudoarthrodesis in this series. Conclusion. TSRH instrumentation is an effective and convenient three-dimensional correction system with a lower rate of complication, which can not only correct the coronal and rotational deformity, but maintain the sagittal alignment as well.

OBJECTIVESTo investigate the diagnosis and treatment cervical disc calcification in children.

METHODS13 children with cervical disc calcification were analysed retrospectively. Cervical pain was observed after influenza in 5 children, suddenly cervical pain in 3, sudden wryneck in 3 cases. Two children with this disease were accidentally found after injury.

RESULTS14 calcifications of cervical disks were found in 13 children. Clinical symptoms disappeared after symptomatic management. Calcification disappeared in 5 months.

CONCLUSIONSCervical disc calcification in children is a kind of benign self-limited disease. Correst understanding of pathophysiologic course of this disease helps to avoid unnecessary surgery.

Adolescent ; Calcinosis ; diagnosis ; therapy ; Cervical Vertebrae ; pathology ; Child ; Child Health Services ; Female ; Humans ; Male

OBJECTIVETo investigate the treatment of infected total knee arthroplasty (TKA).

METHODSBetween 1983 and 2000, 6 patients with infection after TKAs were treated, including 2 men and 4 women, aged on average 63 years (44 - 75 years). Initial knee arthroplasty was performed for osteoarthritis in 4 patients and for rheumatoid arthritis in 2 knees. The timing of diagnosis of infection after knee arthroplasty averaged 50 months (range, 1 month-11 years). Simple debridement and antibiotic treatment were prescribed for 3 patients, debridement and one-stage reimplantation for 1, debridement and two-stage reimplantation for 1, and athrodesis for 1.

RESULTSOf the 3 patients with simple debridement, one was cured, one failed but underwent athrodesis later, and one lost to follow up. Two patients with reimplantation were cured and had good function recovery. All of the 6 patients were followed up on average for 4 years. No infection recurred except one who lost to follow-up.

CONCLUSIONSManagement of infection after total knee arthroplasty includes antibiotic suppression and debridement with prosthesis retention, insertion of another prosthesis as a one-stage or two-stage exchange technique, knee arthrodesis and amputation. These treatments have specific indications. To treat infection after total knee arthroplasty, suitable method should be taken according to patient's condition. Arthrodesis is the best salvage operation, though it may handicap patients' daily life. Reimplantation of another prosthesis could maintain a functional joint.

Adult ; Aged ; Arthrodesis ; Arthroplasty, Replacement, Knee ; adverse effects ; Debridement ; Female ; Humans ; Infection ; therapy ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Reoperation