Objective To investigate the indication,safety and the validity of intervertebral discectomy via posterior approach.Methods There were 8 cases in our group.All received posterolateral intervertebral discectomy and nerve root decompression via posterior approach.The average follow-up period was 5.2 years.The improvement on pain and neurological signs were evaluated.Results Pain disappeared completely in 5 patients and significantly alleviated in the other 3.As to muscle strength and tendon jerk,we observed significant improvement in 6 patients and improvement in the other 2 patients.7 patients got back to their original work and 1 patient shifted to an easy job.No patient had complication.Conclusions Nucleus pulposus removal via posterior approach was a secure and effective one for posterolateral cervical intervertebral disc herniation.

Adult ; Bronchoalveolar Lavage ; methods ; Bronchoalveolar Lavage Fluid ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy

OBJECTIVETo study the effect of Qinghuang Powder (QHP) combined Chinese herbs for Pi-strengthening and Shen-reinforcing (CHPSSR) on hypoxia-inducible factor 1alpha (HIF-1alpha) in bone marrow mononuclear cells of myelodysplastic syndrome (MDS) patients.

METHODSChanges of HIF-1alpha in bone marrow mononuclear cells of MDS patients were detected in 25 MDS patients treated by QHP combined CHPSSR using flow cytometry. Meanwhile, 13 healthy subjects were recruited as the control group. Changes HIF-1alpha levels in various serial bone marrow mononuclear cells were detected.

RESULTS(1) Among the 25 patients in the treatment group, there were 19 patients effective and 6 patients ineffective, with the total effective rate being 76%. (2) Compared with before treatment, levels of peripheral blood WBC, Hb, PLT, and ANC significantly increased in the treatment group after treatment, showing statistical difference (P < 0.05, P < 0.01). (3) Compared with before treatment, the HIF-1alpha mean fluorescence intensity was enhanced in bone marrow lymphocytes, monocytes, granulocytes, and nucleated red blood cells of the treatment group after treatment (P < 0.05, P < 0.01). Compared with the control group, the HIF-1alpha mean fluorescence intensity was weakened in bone marrow lymphocytes, monocytes, and nucleated red blood cells of the treatment group before treatment; while it was obviously enhanced in granulocytes (P < 0.01). But after treatment the HIF-1alpha mean fluorescence intensity increased more in the granulocytes of the treatment group than in those of the control group (P < 0.01), but there was no statistical difference in bone marrow lymphocytes, monocytes, or nucleated red blood cells.

CONCLUSIONQHP combined CHPSSR could improve HIF-1alpha levels in bone marrow lymphocytes, monocytes, granulocytes, and nucleated red blood cells of MDS patients, thus improving Hb levels of MDS patients, and improving their anemia and correlated symptoms.

Adolescent ; Adult ; Aged ; Arsenicals ; therapeutic use ; Bone Marrow ; Bone Marrow Cells ; drug effects ; metabolism ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Monocytes ; drug effects ; metabolism ; Myelodysplastic Syndromes ; drug therapy ; metabolism ; Phytotherapy ; Young Adult

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease (CHD) and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the nonobese group. Obesity and non-obesity were defined based on the body mass index (BMI I (Y) 28.0kg/m2), or waist-hip ratio (men> 0.9, women> 0.85). In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantitatively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria (American Heart Association 1984) and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the nonobese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [(4.35 ± 0.55) and (4.13 ± 0.56) 109/L; (136.71 ± 15.87) and (129.96 ± 16.23) g/L, P < 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CHD than that in the non-obese group with CHD (P<0.05); Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.

Objective　To investigate the clinical feasibility of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system and to summarize the operative technique and outcomes.Methods　From December 2007 to March 2012,22 patients (20 males and 2 females) with the bladder urothelial carcinomas were enrolled.Patient age was from 37 -72 years (rnean 62 years) ; the body mass index was 22.5 - 30.1 kg/m2 ( mean 26.1 kg/m2 ) ; and the American Society of Anesthesiologists score was 1 -2. All patients were diagnosed preoperatively with muscle -invasive or high-risk non-muscle-invasive bladder urothelial carcinomas in cystoscopic biopsy.There were no adjacent organ infiltration,pelvic lymph node involvement or dístant metastasis found on preoperative examinations.The clinical stage of all cases was under T2 N0 M0.Patients were under general anesthesia for RARC with urinary diversion.Extracorporeal urinary diversions (orthotopic ileal neobladder for 2 patients and ileal conduit urinary diversion for 13 patients)were performed on 15 patients and intracorporeal urinary diversions ( ileal conduit urinary diversion for 2 patientsand orthotopic ileal neobladder for 5 patients) were performed on 7 patients.　Results　All RARC procedure were completed on patients as planned.The operative time was 300 - 667 min ( mean 480 min)with estimated blood loss of 100 - 1200 ml (mean 550 ml),and the number of removed lymph nodes was 6 -25 (mean 15). All patients resumed ambulation on the 2nd to 3rd day postoperatively,and bowel function recovered on the 3rd or 4th day postoperatively.The length of hospital stay was 8 - 35 days ( mean 16 days).For patients underwent orthotopic ileal neobladder,the ileoureteral stents and the urethral catheter were removed 1 month after a cystogram confirming watertight healing.During the follow up of 4 -49 months (mean 32 months),2 patients had disease recurrence and 1 patient died of disease development and 2 patients had developed hydronephrosis.The other patients were with good urinary continence and normal renal functions.　Conclusions　RARC with urinary diversion are feasible and safe treatment option for bladder urothelial carcinoma.This technique will be more popular with more extensive surgical experiences and large randomized clinical trials.

Objective To observe the effect of MAP4K4 targeted shRNA on biological characteristics such as proliferation,invasiveness,and apoptosis in human bladder cancer cell.Methods Differentially expressed genes was screened out through cDNA microarray analysis in 5 pairs of fresh-frozen muscle-invasive bladder cancer(MIBC) and adjacent normal tissue obtained from radical cystectomy.Combining the results of genechip and literature review,MAP4K4 was picked up for further analysis.To verify the result of microarray analysis,16 pairs of fresh muscle-invasive bladder cancer (MIBC) and adjacent tissues were assessed for the expression of MAP4K4 mRNA and protein through RT-PCR,qRT-PCR and Western-blot.T24 cell line was stably trasfected with MAP4K4 targeted shRNA and control shRNA,respectively.The effects of MAP4K4 silencing on proliferation,invasiveness and apoptosis of T24 cells transfected with MAP4K4 targeted shRNA and control shRNA were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT),transwell and flowcytometry (FCM) assay.Results MAP4K4 was overexpressed in muscle invasive bladder cancer than in normal tissue.Down regulation of MAP4K4 expression decreased bladder cancer cell proliferation(MAP4K4-targeted versus control,P＜0.001),invasiveness(MAP4K4-targeted versus control,P=0.004)and promoted cell apoptosis(MAP4K4-targeted versus control,P=0.023).Conclusions MAP4K4 is overexpressed in muscle invasive bladder cancer than in normal tissue.Down-regulation of MAP4K4 expression inhibits the invasive ability of bladder cancer.Therefore,MAP4K4 might be a potential therapeutic target for bladder cancer.

Objective Systemic chemotherapy for metastatic pancreatic cancer is still a difficult problem in clinical practice. The standard chemotherapy of pancreatic cancer has been gemcitabine, but the response rate is low. Therefore, it is in urgent need to explore an effective clinical therapy for this cancer. This paper, a case report, is aimed at discussing the effectiveness of vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer. Methods A 52-year-old female patient was diagnosed with pancreas cancer with liver metastasis at the time of the first visit to our hospital. Systemic chemotherapy with vinorelbine and cisplatin combined with endostatin was conducted. Results Liver metastases almost disappeared after the first cycle of chemotherapy. The primary tumor decreased by one third in size after four cycles and disappeared after the sixth cycle according to the CT scan evaluation. Conclusion Vinorelbine and cisplatin combined with endostatin can be a promising regimen for metastatic pancreatic cancer.

OBJECTIVETo develop a three-dimensional (3-D) comparison and measuring techniques to analyze changes in palatal forms of the serial maxillary alveolar cast and to evaluate the significance of the different reference change indexes.

METHODSFollowing digitizing the casts with a 3-D laser scanner and using reverse engineering software Geomagic Studio 7.0 for a pair of 3-D digital maxillary alveolar cast of an infant of UCLP before and after cheiloplasty, a pair of cast surfaces were reconstructed. The reference points and the character lines were extracted.

RESULTSThe model coordinate system and the datum planes were established on the basis of reference points extracted. The newly developed analysis technique completed 3-D comparison of palatal forms of UCLP infants before and after cheiloplasty. Distances and volumes changes between the surfaces were determined and expressed graphically.

CONCLUSIONSWith establishing the model coordinate system and the datum plane, it is possible to visualize the comparison outcome of the reference change indexes longitudinally. The various reference change indexes may reflect the trend of the infant maxillary growth.

Alveolar Process ; growth & development ; pathology ; Cleft Lip ; pathology ; surgery ; Cleft Palate ; pathology ; surgery ; Dental Models ; Humans ; Imaging, Three-Dimensional ; methods ; Infant ; Male

OBJECTIVETo reconstruct a digital maxillary cast of infants with cleft lip and palate (CLP) by laser scanning and to provide an analysis method for the edentulous cast of CLP.

METHODSUnder general anesthesia, an edentulous cast of one infant with right CLP was made and scanned by laser scanner. Using reverse engineering software, this cast surface was reconstructed.

RESULTSBy this method, the digital cast could be observed from each degree and direction, and on this digital cast, the reference landmarks formeasarenment were determined, and the cast was then segmented, measured, and calculated.

CONCLUSIONSThe 3-D analysis developed is an ideal tool for the examination of 3-D morphological changes in the edentulous maxilla of patients with CLP. This newly developed analysis enables a quantification of the extent and direction of morphological changes in the maxilla of infants with CLP.

Alveolar Process ; growth & development ; pathology ; Cleft Lip ; pathology ; surgery ; Cleft Palate ; pathology ; surgery ; Dental Models ; Humans ; Imaging, Three-Dimensional ; Infant ; Male ; Maxilla ; growth & development ; pathology

Objective To evaluate the correlation between regional blood perfusion and biological features of breast cancer. Methods Spiral CT technique was applied to quantitatively detect the central and marginal blood perfusion, including blood flow ( BF ) , blood volume ( BV) and permeability of surface (PS). Results The central and marginal blood perfusion of breast cancer were significantly higher than that of normal breast tissues. The marginal blood perfusion was higher than central blood perfusion. The regional blood perfusion of breast cancer varied with tumor size, clinical stage and histological grading. Conclusion The regional blood perfusion correlates with biological markers in breast cancer and can be used to evaluate the biological characteristics as a noninvasive marker before neoadjuvant chemotherapy.