Objective To assess the relationship between reconstruction of coronal trunk shift and changes of unfused segments after selective posterior thoracolumbar/lumbar curves fusion for idiopathic scoliosis.Methods Radiographic data of patients with thoracolumbar/lumbar idiopathic scoliosis who underwent selective posterior correction at our hospital from October 2005 to October 2011 with a minimum of 2 year follow-up period was retrospectively analyzed.Posteroanterior and lateral radiographs of the whole spine before surgery,after surgery and at the last follow-up were performed.Changes of coronal trunk shift during follow-up period were observed and multiple linear regression analysis was performed to determine its relationship with changes of upper thoracic curve,main thoracic curve,lumbar curve,distal unfused segments and coronal sacral inclination.Results Thirty-seven patients with 4 males and 33 females were included in this study.The average age was 14.6±2.0 years (range,12-20 years).The mean follow-up period was 3.6 years (range,2-8.9 years).The mean preoperative Cobb angles of lumbar and thoracic curve were 44.2° and 25.2°,respectively.At the last follow-up,they were corrected to 10.3° and 13.6°,indicating 75.7％ and 44.9％ correction rate,respectively.The pre-and post-operative mean trunk shifts were 2.2 cm and 2.0 cm with no significant differences.At the last follow-up,it compensated to 0.9 cm,which showed significant differences compared with that of postoperation.Linear regression analysis suggested that trunk shift changes during follow-up period were only correlated with changes of distal unfused segments.The regression equation could be described as Changes of trunk shift (cm) =1.248 7+0.137 8×Changes of distal unfused segments (°).Conclusion The reconstruction of coronal trunk balance is mainly compensated by distal unfused segments after selective posterior correction for thoracolumbar/lumbar idiopathic scoliosis.Although preserved most of its levels,unfused thoracic segments do not play an important role in the reconstruction of trunk shift.

Objective To retrospectively analyze pulmonary function changes after growing rod surgery for progressive early-onset scoliosis.Methods Ten cases of progressive early-onset scoliosis treated with growing rod technique from September 2002 to July 2011 were enrolled in the study.There were 3males and 7 females,aged from 6 to 9 years (average,7.0±1.1 years).Four patients had finished the final fusion surgery (Group fusion),and 6 patients (Group non-fusion) were in the process of periodic lengthening.Forced vital capacity (FVC),FVC/predicted FVC ratio,forced expiratory volume in one second (FEV1),FEV1/predicted FEV1 ratio,Cobb’s angle,and C7-S1 distance before each surgery were recorded.Lung function changes and correlations between lung function changes and radiographic changes (Cobb’s angle and C7-S1 distance) were analyzed.Results In Group fusion,both FVC and FEV1 increased,and FVC showed a significant difference.In Group non-fusion,FVC and FEV1 also increased and both showed a significant difference.FVC/predicted FVC ratio and FEV1/predicted FEV1 ratio both changed similarly and did not show statistical differences in the two groups.There were no significant correlations between lung function changes and radiographic changes (Cobb’s angle and C7-S1 distance).Conclusion Pulmonary function improves after growing rod surgery for progressive early-onset scoliosis.The pulmonary function changes do not correlate with changes of Cobb’s angle and C7-S1 distance.

Objective To investigate the expression of PTEN and vascular endothelial growth factor (VEGF) in esophageal carcinoma and the relationship between their expression.Methods The expression of PTEN and VEGF were detected using immunohistochemical S-P method.Results Among 80 cases of esophageal carcino- ma,31 showed positive staining of PTEN (38.75%),while all 20 case of normal mucosa showed positiva staimng of PTEN.The expression level of PTEN in highly differentiated squamous carcinoma was higher than that low differ- entiated squamous carcinoma.Also,the expression of PTEN was significantly correlated with lymph node metastasis (r=0.61,P<0.01)and differentiation(r=0.57.P<0.05).In 80 cases of esophageal carcinoma,57(70.13%) were of positive staining of VEGF,while in 20 of normal esophageal mucosa,only 3 showed positive staining of VEGF.The expression of VEGF was markedly correlated with infiltrative deepness(r=0.49,P<0.05)and lymph node metastasis(r=0.55,P<0.05)and differentiation(r=0.48,P<0.05).Conclusion Combined detection of PTEN and VEGF maybe helpful to evaluate prognosis and infiltrative capability of esophageal carcinoma,with sig- nificant importance to the prediction of the prognosis of esophageal carcinoam.

Objective To investigate the treatment of septic shock(SS) from upper urinary obstruction(UUO). Methods Continuous veno-venous haemofiltration(CVVH) combined with surgical method was applied to 42 SS patients from UUO. Their general conditions, liver and kidney functions, APACHE Ⅱ, therapeutic intervention scorisystem(TISS), multiple organ dysfunction syndrome (MODS), complication rate and main outcomes were analysed comparing with traditional therapies groups(n=30). Results Compared with those traditional therapies, the APACHEⅡ , MODS and TISS score decreased (P＜0.05). Thirty-seven out of 42 patients survived and the survival rate was 88.0% during ICU. Conclusion CVVH combined with surgical methods may effectively decrease the incidence of complications and mortality of SS from UUO, and the mechanism may be related to the remove of mediators of inflammation.

ObjectiveTo analyze the prognosis of the new occurred proximal thoracic(PT) curve after posterior correction surgery in adolescent idiopathic scoliosis (AIS) patients.MethodsThe radiographs of 21 AIS patients,who had a primary main thoracic (MT) curve and suffered from a new PT curve after posterior correction surgery,were retrospectively reviewed.All patients were followed up for an average of 19.8 months.Imaging parameters including coronal Cobb angle,T1 tilt and radiographic shoulder height,were measured and analyzed.ResultsThe average coronal Cobb angle of the MT curve was 54.3° preoperatively,14.1° at the final follow-up,with an average correction rate of 74.6％.Before operation,5 patients had negative T1 tilt and 16 without T1 tilt.After operation,all the 21 patients had positive T1 tilt and new PT curves;the average T1 tilt was 6.0° and the average coronal Cobb angle of the PT curve was 16.0°.At the final follow-up,the average T1 tilt and coronal Cobb angle of the PT curve were 4.0° and 13.2°,respectively; eighteen patients still had positive T1 tilt and 17 patients still had PT curves larger than 10°.As for the radiographic shoulder height,5 patients had equal shoulders and 16 patients had right shoulder elevation before operation; after operation,19 patients had left shoulder elevation and 6 patients had unbalanced shoulders; at the final follow-up,14 patients still had left shoulder elevation and 5 patients had unbalanced shoulders.At the final follow-up,T1 tilt and coronal Cobb angle of the PT curve were better than those postoperatively immediately,while the incidences of the new PT curve,left shoulder elevation,unbalanced shoulders were all not significantly different from those postoperatively immediately.ConclusionThe new occurred PT curves after posterior correction surgery in AIS patients are difficult to be compensated and could cause shoulder imbalance,thus great attention should be paid to prevent the occurrence of the PT curve.

Objective To evaluate the efficacy and safety of thromboprophylaxis with low molecular weight heparin after lumbar decompressive surgery.Methods Between January 2004 and April 2011,patients who had undergone lumbar decompressive surgery and had high or very high risk of venous thrombosis were selected.All patients received subcutaneous injection of low molecular weight heparin (Fraxiparine),starting at 6 hours after surgery with a half dose and subsequently once every 24 hours with full dose until discharge.When 24-hour drainage volume was less than 50 ml,the drainage tube was removed 2 hours prior to low molecular weight heparin administration.The occurrences of deep venous thrombosis (DVT),pulmonary embolism (PE),bleeding complications and side effects were recorded.Results Seventy eight patients were enrolled in the study.The average time of drug use was 8.5 days.No symptomatic DVT,PE and major bleeding events occurred.Drainage tube was placed in all patients except 3 patients with lumbar disc herniation.The mean total drainage volume was (319.5±218.5) ml,and the average time from operation to removal of drainage tube was (43.2±14.4) hours.Incision site ecchymosis occurred in 1 patient,incision bleeding in 1 patient,mild elevation in hepatic aminotransferase levels in 4 patients,and mild anaphylaxis in 1 patient.Conclusion It is effective and safe to prevent VTE with low molecular weight heparin for patients with high or very high risk of venous thrombosis after lumbar decompressive surgery.

Objective To retrospectively analyze the application of single and dual growing rod techniques in treatment of early onset scoliosis,and compare the early results of two techniques.Methods Retrospective study was done on 18 cases of early onset scoliosis treated with growing rod technique from November 2002 to March 2009.Single growing rod group included 5 cases and dual growing rod group included 13 cases.We compared the operation time,intra-operative bleeding,correction rate,changes in distance between C7-S1 and incidence of complications of the first operation between two techniques.Results The average post-operative follow-up duration was 39.9 months (14-89).There was no difference in operation time,intra-operative bleeding and incidence of complications between two techniques.There was no difference in preoperative coronal Cobb angle and preoperative sagittal Cobb angle between single growing rod group and dual growing rod group.Correction rate of dual growing rod group was significantly superior to single growing rod group in coronal plane (P＜0.01),but not in sagittal plane.Increase of the distance between C7-S1 dual growing rod group was significantly larger than the single growing rod group (P＜0.05).Conclusion Growing rod technique is an effective option for early onset scoliosis.Dual growing rod technique is relatively superior to single growing rod technique in correction outcomes.

Objective:To compare and observe the different clearance effect of milk containing anti-Helicobacter pylori specific antibody. Methods:Four H. pylori strains were used to immune dairy cows to obtain milk containing anti-Helicobacter pylori specific antibody,of which,one was standardized strain and the other three were locally epidemic. Totally 148 people were screended,in which 72 were C-14 urea breath test positive, finally 39 meet the criteria. They were divided into two groups, the test group contained 21 subjects,were treated milk containing anti-Helicobacter pylori specific antibody;the 18 subjects in control group with common milk. The study was continued for 2 months. Results:Conducting the C-14 urea breath test,9 subjects in test group were negative,but no one was changed in control group. The effective clearance rate of the test group was 42. 86%,and there was no effective clearance in the control group,so there was significant difference in the two groups(P=0. 005,P<0. 05). Conclusion: The milk containing anti-Helicobacter pylori specific antibody is polyclonal and has higher valence,and could clear H . Pylori effectively.

Objective To investigate the suitable treatment of post operative anastomotic recurrence after anterior resection of rectal cancer and analyze the relationship between different kinds of therapy with prognosis. Methods The clinical data of 41 cases of local recurrent rectal cancer after anterior resection admitted in our hospital from 1999 to 2009 were analyzed retrospectively. The median survival time and survival rate were calculated by Life Tables method. The influence of different kinds of treatment to prognosis was evaluated by Kaplan-Meier method and the variability was analyzed by Log-rank method. P <0.01 means statistical significance. Results Thirty-three (80.5 %) of 41 patients were recurrent in the first 3 years and the median survival time was 23 months. Seventeen (41.5 %) of 41 patients underwent radical R0 resection. The median survival time of radical resection patients and non-radical resection ones were 49 months and 18 months, respectively, and the difference was significant (χ2=12.245, P=0.000). Thirty-one patients with radiotherapy and/or chemotherapy showed a statistically longer median survival time than the other 10 patients without these adjuvant treatment (39 months and 9 months, respectively) (χ2=17.533, P =0.000). Conclusion Most post operative anastomotic recurrent of rectal cancer cases occurs in the first 3 years after primary surgery. Radical resection, radiotherapy and chemotherapy can improve the prognosis.

Objective To investigate the clinical characteristics and analyze prognostic risk factors of combined hepatocellular-cholangiocarcinoma. Methods The clinical data of 19 cases of combined hepatocellular-cholangiocarcinoma admitted in our hospital from January 1999 to December 2009 were analyzed retrospectively. The survival function was analyzed by Kaplan-Meier. The possible prognostic risk factors were tested by χ2-test. Results Hepatocellular-cholangiocarcinoma was diagnosed by pathology in the 19 patients, among which hepatic tunic was infiltrated in 13 cases, peritoneum involved in 1 case, intravascular cancer embolus in 1 case. At that time lymphocyte nodes metastasis in 2 cases were found by regional lymphadenectomy in 7cases. The 1-year and 3-year survival rates were 61% and 42%,respectively. Prognosis of patients with tumor size ＞ 5 cm ( χ2 = 4. 392, P = 0. 036 ), history of heavy drinking ( χ2 = 11.010, P = 0.001 ) or intraoperative blood transfusion ( χ2 = 4. 645,P = 0. 031 ) were worse than others. Conclusion It was difficult to get correct preoperative diagnosis of combined hepatocellularcholangiocarcinoma. Tumor size, history of heavy drinking and blood transfusion were all prognostic related risk factors.