OBJECTIVE To investigate the effect of repeated debridement on the efficacy of endoscopic sinus surgery(ESS). METHODS A total of 67 patients underwent ESS were divided into intervention group and control group. Debridement was performed at the 1st, 4th, 8th week after operation for the patients in intervention group, while once per week for the patients in control group. The primary outcome measure was visual analogue scale(VAS)and Lund-Kennedy endoscopic score(LKES). RESULTS Comparing the two groups on all domains of digital VAS and LKES at the 4th, 8th week after operation, there were no significant difference between the two groups. CONCLUSION Benefit of frequent debridement during the early postoperative period was no positive correlation with patients recovering after ESS. Therefore, in terms of subjective recovery and health care costs,appropriate extending postoperative management time and decreasing intervention frequency do not decrease the efficacy of endoscopic sinus surgery.

Objective To investigate the related risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) of osteoporotic vertebral compression fracture.Methods A retrospective study was made on 108 patients (114 vertebrae) undergone PVP and PKP between January 2008 and June 2014.There were 32 patients with cement leakage and 76 patients without cement leakage.Between-group differences were analyzed in terms of gender,age,number of one-time treated vertebrae,anatomic dissection,surgical procedures (PKP or PVP),integrity of the posterior vertebral wall,puncture approaches (unilateral or bilateral),technical level of surgeons and bone cement volume.Results Bone cement leakage occurred in 36 vertebrae (with the proportion of 31.6％).Cement leakage was associated with number of one-time treated vertebrae,surgical procedures,fractured condition,and bone cement volume (P ＜ 0.05),but not with gender,age,anatomical site of injury,puncture approaches,and technical level of surgeons (P ＞ 0.05).Conclusions Bone cement leakage after PKP or PVP correlated with number of vertebrae with one-time therapy,surgical procedures,fractured condition,and volume of bone cement.A good master of technical procedures and indications and suitable injection of high viscosity bone cement can help reduce the incidence of cement leakage.

Objective To determine if fetal stem cells can enter the maternal circulation during pregnancy and re-pair the injuries of maternal heart.Methods C57 female mice at the age of 6-8 weeks were randomly assigned to three groups:sham control, surgery without pregnancy, and surgery with pregnancy ( n=8,eath group) .The control sham group was developed by opening and closing of the chest.The other two groups underwent heart surgery.The myocardial infarc-tion ( MI) model was induced by ligation of the left anterior descending coronary artery.Half of the surgical mice mated with e-GFP transgenic male mice, and another half group was not.Electrocardiogram ( ECG) and echocardiographic images were recorded at pre-operation, post-operation and postpartum.The collected data were used to evaluate the heart function. The GFP expression was detected by immunohistochemistry and q-PCR.Results When compared with the sham group, both the ischemia surgery groups with and without pregnancy, the ECG ST segment was significantly increased.This meas-urement indicated that the myocardial ischemia surgery was successful, and no significant difference in the ST segments be-tween two ischemia surgery groups was found.However, when ECG was measured in the surgical mice after postpartum, their myocardial ischemia was dramatically improved when compared with that of the ischemia surgery only mice.Echocar-diographic images also indicated that both the surgery groups had myocardial ischemia, however, no significant difference was observed in the pregnant mice before and after postpartum.The order of the cardiac function indexes from high to low was the sham group, surgery with pregnancy group, and surgery with no pregnancy group;in particular, the cardiac func-tion of pregnancy group was significantly enhanced compared with that of the surgery with no pregnancy group (P<0.05). More importantly, both immunofluorescence and q-PCR results showed that the embryonic stem cell translocation through circulation system with GFP expression in the heart of pregnancy group, while negative in other two groups.Conclusions Embryonic stem cells can be transferred into the maternal circulation of pregnant mice, and play a role in the repairing of their cardiac injuries.

Objective To investigate the effects of glycyrrhizin on gene expression of transforming growth factor(TGF)-?signaling pathway of hepatic stellate cell(HSC)in mice by gene microarray tech- nique.Methods The HSCs were isolated from mice and cultured in vitro.Then the mice were divided into control group,TGF-?_1 group(5 ng/ml) or TGF-?_1(5 ng/ml)combined with glycyrrhizin(100?mol/L) group.The cells were collected after 10 hours to extract RNA.A cDNA microarray(GEArray~(TM) Q) targeting TGF-?/BMP signal transduction was used to screen the genes which showed significant changes in expression of TGF-?pathway of HSC by glycyrrhizin.Results The microarray analysis showed that 16 genes(16.7%),such as Smad2,Smad3,Smad7,CoL3A1,CoL1A2,and PAI-1,were upregulated by TGF-?_1 and then down-regulated by glycyrrhizin.Five genes(5.2%)(including BMP7,IGFbp3 and etc.)downregulated by TGF-?_1,were then up-regulated by glycyrrhizin.Finally,2 genes upregulated by TGF-?_1 were then up-regulated predominantly by glycyrrhizin in HSC(T?R2,betaglycan).Changes in some genes,such as Smad2 Smad3,Smad7,were further confirmed to be coincided with cDNA microarray by semi-quantitative RT-PCR.Conclusions The anti-fibrosis mechanisms of glycyrrhizin may be through to interference of TGF-?signaling pathway,decrease the synthesis and increase the degradation of collagen.

Objective To cstimnate the diagnostic performance of computer tomography (CT) and magnetic resonance imaging (MRI) for detecting metastasis in pelvic lymph nodes with normal size in patients with bladder cancer.Methods hnaging of CT and MRI and clinical data of 118 patients who underwent radical cystectomy and pelvic lymphadenectomy were reviewed.The diagnostic efficacy of CT and MRI were analyzed when taking lymph nodes short axis diameter ≥0.3 cm and ≥ 1.0 cm respectively as diagnostic criterion of metastasis with corTelation of pathological results.Results 22.7％ (27/118) of patients were confirmed lymph nodes malignancies among 118 patients based on pathology.Totally 1 705 lymph nodes were detected in surgery and 119 of them were observed malignancy according to pathological presentation.The malignant nodes were mainly distributed in the perivesical (35.4％,41/119),internal iliac (12.6％,15/119),external iliac (30.3％,36/119),obturator region (21.0％,25/119) and presarcal region (1.7％,2/119).Imaging of CT and MRI showed that when taking nodes with ≥0.3 cm in maximum short-axis diameter (MSAD) as positive,the sensitivity (Se),specificity (Sp),and positive predictive values (PPV) were 16.0％,99.2％,54.2％ and 56.5％,99.2％,86.7％ respectively.While taking MSAD≥1.0 cm as malignant,the Se,Sp and PPV of CT and MRI were 6.2％,99.9％,83.3％ and 13％,100％,100％ respectively.When taking MSAD ≥0.3 cm as positive,the Se and PPV between CT and MR were statistically different(P ＜ 0.001 and P =0.036,respectively).When taking MSAD ≥ 1.0 cm as positive,there was no statistically difference (P =0.275 and 1.000,respectively).Conclusions The incidence of normal-sized lymph node metastasis was higher in patients with bladder cancer.At this phase the MRI evaluation was superior to that of CT.When the MSAD ≥ 1.0 cm,there was no significant difference between CT and MRI.

AIM: To study the characteristics of retinal detachment surgery after laser 　in situ　 keratomileusis (LASIK).METHODS: Eleven eyes of ten patients that experienced rhegmatogenous retinal detachment after LASIK procedure participated in the study. The characteristics of retinal detachment, management and complications after surgery were analyzed . RESULTS: Retinal detachment was characterized by the large percentage of multiple peripheral holes (73%) and giant tears (27%). All eyes underwent sclera buckling, and three of them combined with pars plana vitrectomy (PPV) and silicone oil tamponade. Silicone oil was removed after 1 month. Retina was reattached successfully at the first retinal detachment surgery in all eyes except one that succeeded at the fourth time. One eye of LASIK flap dehiscence and one eye of corneal subepithelial opacity occurred after surgery.CONCLUSION: Patients after LASIK should be carefully examined under pupillary dilation during follow-up. Sclera buckling is necessary to most retinal detachment after LASIK, and corneal protection is important in the treatment.

Objective To study the clinical outcomes of titanium-coated interbody fusion system in treating lumbar isthmic spondylolisthesis.Methods A retrospective study was made in 22 cases with lumbar isthmic spondylolisthesis including 15 with degree I spondylolisthesis and seven with degree II spondylolisthesis treated by posterior lumbar interbody fusion using titanium-coated fusion cages from June 2002 to December 2003 in our hospital.There were six males and 16 females,with age range of 41-68 years(mean 52.5 years).In all cases,double cages were implanted with additional posterolateral bone graft,supplemented with pedicle screw systems.The average preoperative and postoperative disc space height,foraminal height,segmental and lumbar lordosis,spondylolisthesis and domain of sagittal rotation on flexion-extension radiographs were measured and fusion state observed.The Oswestry disability index (ODI)was used to evaluate the clinical outcome.Results The fusion rate was 95.4%.There was significant recovery of disc space height,foraminal height and domain of sagittal rotation.ODI decreased significantly.Conclusion The anatomic titanium-coated fusion system is effective and safe in treatment of lumbar isthmic spondylolisthesis because it has advantages in restoring sagittal alignment and keeping bony endplate intact.

Objective To observe the clinical effect of Yiqi Yangyin Huoxue decoction(the function of decoction is to tonify Qi,nourish Yin and enhance blood circulation)on salivary gland response attribute to radiotherapy.Methods This study,carried between January 2005 and December 2005,focused on the effect of Chinese herbs on salivary gland response attribute to radiotherapy.In the treatment group,30 cases took Chinese herbs during the duration of radiotherapy,while in the control group 30 cases were given routine therapy.Results Both groups had finished the radiotherapy,however,in the control group,there were 5 cas- es with a break for 1～2 weeks.For the comparison of the salivary gland change in acute stage,there was no variance(x~2=2.387,P=0.122);the latency for the salivary gland change in treatment group was longer than that in control group(x~2=13.106,P=0.000).For the comparison of Karnofsky after radiotherapy,the KS was superior in the treatment group than that in control group(x~2=12.685,P=0.013);For the comparison of objective effect after radiotherapy,the remission rate in treatment group was 90 %,and it was 86.7 % in control group(x~2=0.638,P=0.727).Conclusion The decoction can remit the salivary gland response caused by radiotherapy in clinic,prolong the latency for acute radioactive response;release the pain of the pa- tients,increase the achievement ratio for radiotherapy,and improve the patients'living condition.To combine with radiotherapy,Chinese herbs is a good supplemental therapy for nasopharyngeal carcinoma

Microbe cell-surface engineering , which use the microbe cell surface display technology to display foreign proteins on the microbe cell surface to produce cell-surface proteins, was developed in recent years. I t can be utilizedto develop cell-catalyst, cell-adsorbent , live vaccine, biosensor and so on, and have a wide application perspective. But in our county, the microbe cell-surface engineering is studied just now. This review explain the development of the microbe cell surface engineering, overview the study and progress of microbe cell-surface engineering, and look this technology into the future.

Objective To explore the changes of the hippocampal formation and the myelinated nerve fibers in the hippocampal formation of aged female Long-Evans rat. Methods The hippocampal formation and the myelinated nerve fibers in the hippocampal formation of 5 young (6-month old), 5 middle-aged (18-month old) and 6 aged (28-month old) female Long-Evans rats were quantitatively investigated with the stereological techniques and transmission electronic microscope technique. Results There were no significant changes in the volume of hippocampal formation, the volume density, the total volume, the length density and the mean diameter of the myelinated nerve fibers in the hippocampal formation among young, middle-aged and aged rats. When compared to that of young rats, the total length of the myelinated nerve fibers in the hippocampal formation of middle-aged rats was significantly increased by 63.6%. When compared to that of middle-aged rats, the total length of the myelinated nerve fibers in the hippocampal formation of aged rats was significantly decreased by 47.5%. When compared to that of young rats, the total length of the myelinated nerve fibers in the hippocampal formation of aged rats was non-significantly decreased by 13.8%. Conclusion Although the reason why the total length of the myelinated nerve fibers in the hippocampal formation of middle-aged rats was longer than that of young rats needs further investigations, the present results together with our previous findings in white matter and cortex further suggest that there are age-related changes of the myelinated nerve fibers in the normal aged brains.