BACKGROUND:Patients with spinal metastases may appear different degrees of pain and abnormal spinal stability, and can be treated with percutaneous baloon kyphoplasty combined with bone cement implantation. OBJECTIVE:To explore the effect of percutaneous baloon kyphoplasty with bone cement implantation on spinal stability and pain in patients with spinal metastases. METHODS:Twenty-three patients with metastatic spinal tumor were treated with percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement. There were 10 females and 13 males, and their age ranged from 23 to 71 years. The visual analogue scale score, anterior and posterior edge height of vertebral body, quality of life, and motor function score of patients were observed before and after treatment. RESULTS AND CONCLUSION: Compared with before treatment, the visual analogue scale score and motor function score were significantly decreased, while anterior and posterior edge height of vertebral body were significantly increased in 23 patients at 24 hours after treatment (P < 0.05). After 12 months of folow-up, no case appeared to have spinal nerve root damage, serious adverse reactions and bone cement embolism. The patient'squality of life was significantly improved, compared with before treatment (P < 0.05). Experimental findings indicate that percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement can significantly improve the spinal stability, relieve the degree of pain, and exert exact effects in treatment of spinal metastases.

To observe the effect of Mycobacterium tuberculosis 19 kDa lipoprotein (Mtb P19) upon the expression and distribution of Toll-like receptor-2 (TLR-2) on the surface of macrophages, Mtb P19 was prepared from the cultured M.tuberculosis H37 Ra strain , and phorbol myristatye acetate (PMA)-differentiated THP-1 cells were co-cultivated with Mtb P19 at concentration of 10 g/mL and at 37 ℃ temperature and a condition containing 5% CO_2.for 6 hours.. The distribution of TLP-2 on the surface of macrophages was investigated by immuno-cellular chemical method (ICC) while the effect of Mtb P19 upon the expression of TLR on the surface of macrophages was assayed by fluorescent antibody staining. In addition,the changes of TLR-2 expression before and after the effect of Mtb P19 were investigated by flow cytometry analysis and change of TLR-2 arrangement after stimulation with Mth P19 was determined by co-focal microscopy. It was found that the TLR-2 molecules were evenly distributed on the surface of macrophages as demonstrated by ICC. The mean fluorescent intensity increased significantly after stimulation with Mtb P19 for 6 hours in comparison with that of the control group, and the patchy surface with fluorescent staining positive zones could be detected on the surface of macrophages. Nevertheless , the distribution of TLR-2 molecule in the control group appeared to be randomly dynamic. It is evident that the Mth P19 not only can induce the surface expression of TLR-2 molecules, but also cause a functional aggregation of this receptor.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

ObjectiveTo investigate the cause,diagnosis and treatment measures of neonatal pneumothorax.MethodsThe clinical data of 98 cases with neonatal pneumothorax in our hospital from Mar 2005 to Mar 2010 were reviewed retrospectively.ResultsThere were 27 premature neonates and 71 full-term neonates in the 98 cases.Ten cases were spontaneous pneumothorax and 88 cases were non spontaneous pneumothorax.After the treatnent of primary disease,pleural aspiration,chest drainage and mechanical ventilation,88 cases were cured,8 cases were improved and 2 cases died.ConclusionNeonatal pneumothorax is related with cesarean section,improper use of endotracheal intubation,meconium aspiration,premature hyaline membrane disease using pulmonary surfactant and ventilator therapy.Most pneumothorax is due to lung disease.The prevention of preterm birth and asphyxia can reduce the incidence of neonatal pneumothorax.

Adolescent ; Dermatitis Herpetiformis ; complications ; Esophageal Diseases ; etiology ; Humans ; Male ; Mucous Membrane ; pathology

Objective To study the risk factor of postoperative acute lung injury(ALI)after liver transplantation.Methods The clinical data of I00 patients with end-stage liver diseases who re- ceived liver transplantations were retrospectively reviewed.The risk factors of postoperative ALI after liver transplantation were analyzed by using single variance analysis and multiple variance regression analysis.Results Thirteen patients(13 %,13/11t0)altogether were diagnosed as ALI after liver transplantation.Binary logistic analysis revealed that massive transfusion during operation(more than 5000 ml)and severity of reperfusion injury(ALT above 600 U/L)were two independent risk factors of postoperative ALI following liver transplantation.Massive transfusion significantly increased the risk of ALI by 12.7 times,whereas the severe reperfusion significantly increased the risk of ALI by 7.0 times.Conclusions ALl is a serious multifactoral complication after liver transplantation with high mortality and fatality.Massive transfusion and the severe reperfusion injury are two independent risk factors with high morbidity and mortality.

Different from the traditional teaching method, PBL (Problem-Based Learning) teaching mode is emphasized to foster the students' skills in spontaneous study and problem solving and the analyzing and comprehensive thinking ability. The authors believe that in the application of the PBL teaching method, the teachers' functions should be stressed on how to select the initial moment, provide the topics, excite the interesting points, search information,make comments and evaluate the students' ability, i.e. to offer fish and teach how to catch fish as well.

To observe the influence of Mycobacterium tuberculosis 19-kDa lipoprotein (Mtb P19) on function and phenotype of macrophage,the Mtb P19 was prepared from cultured Mtb H37Ra and the phorbol myristate acetate-differentiated THP-1 cells were incubated with P19 at the concentration of 10 μg/mL with 5% CO_2 at 37℃ for up to 48 hours.Supernatants were collected for TNF-α and IL-6 detection by ELISA,then the phenotype fluorescent antibodies were stained to analyze HLA-DR expression changes between control group and experimental group.Flow cytometry and microscopy was used to assay the phagocytosis in macrophages stimulated by Mtb P19.IL-6 and TNF-α in collected supernatants were detected.Results indicated that both were found significant increases and their phagocytosis were enhanced.Comparing to the control group,the mean fluorescence intensity showed a significant increase 24hs after stimulation.It presents that Mtb P19 could be able to induce macrophages activation,and it would be significantly important for protection during infection period.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

Objective To investigate the importance of elements of teaching aesthetic(appearance aesthetics; language aesthetics; emotion aesthetics; PPT aesthetics; blackboard-writing aesthetics and model aesthetics) in clinical orthopaedic teaching,and to analyze the reasons and significance of them.Methods Totally 137 medical students(2005 and 2006 grade) were investigated by the questionnaire in resent 2 years.They were asked to choose the first two important elements of teaching anesthetic from six elements displayed by four teachers.Results The percentage of appearance aesthetics,language aesthetics,emotion aesthetics,PPT aesthetics,blackboard-writing aesthetics and model aesthetics were showed as 97.4％,88.7％,67.1％,58.9％,13.6％ and 1.2％ respectively.Conclusion Teaching aesthetics is an indispensible part of teaching aesthetically and it is helpful to promote the teaching.We should be focus on PPT aesthetics and appearance aesthetics,which show high percentage in our research.